• Title/Summary/Keyword: LOWER ARM

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Assessment of Effect of Pulmonary Rehabilitation on Skeletal Muscle Metabolism by $^{31}P$ Magnetic Resonance Spectroscopy (호흡재활치료 전후 $^{31}P$ 자기공명분석법을 이용한 골격근대사의 변화에 관한 연구)

  • Cho, Won-Kyung;Kim, Dong-Soon;Choe, Kang-Hyeon;Park, Young-Joo;Lim, Tae-Hwan;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1040-1050
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    • 1997
  • Pulmonary rehabilitation has been known to improve dyspnea and exercise tolerance in patients with chronic lung disease, although it does not improve pulmonary function. The mechanism of this improvement is not clearly explained till now; however some authors suggested that the improvement in the skeletal muscle metabolism after the rehabilitation could be a possible mechanism. The metabolc changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation which causes early activation of anaerobic glycolysis and excess lactate production with exercise. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the improvement in the exercise tolerance after the rehabilitation, noninvasive $^{31}P$ magnetic resonance spectroscopy(MRS) of the forearm flexor muscle was performed before and after the exercise training in nine patients with chronic lung disease who have undertaken intensive pulmonary rehabilitation for 6 weeks. 31p MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntary contraction(MVC) force of the muscle was measured before the isometric exercise, and then 30% of MVC force was constantly loaded to each patient during the isometric exercise. After the exercise training, exercise endurance of upper and lower extremities and 6 minute walking distance were significantly increased(p<0.05). There were no differences of baseline intracellular pH (pHi) and inorganic phosphate/phosphocreatine(Pi/PCr). After rehabilitation pHi at the exercise and the exhaustion state showed a significant increase($6.91{\pm}0.1$ to $6.99{\pm}0.1$ and $6.76{\pm}0.2$ to $6.84{\pm}0.2$ respectively, p<0.05). Pi/PCr at the exercise and the recovery rate of pHi and Pi/PCr did not show significant differences. These results suggest that the delayed intracellular acidosis of skeletal muscle may contribute to the improvement of exercise endurance after pulmonary rehabilitation.

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Biomechanical and Physiological Comparative Analysis of the Single-Radius Knee Arthroplasty Systems and Multi-Radius Knee Arthroplasty Systems (무릎인공관절 단축범위(Single-Radius) 수술자와 다축범위(Multi-Radius) 수술자의 운동역 학적 및 운동생리학적 비교분석)

  • Jin, Young-Wan;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.18 no.11
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    • pp.1532-1537
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    • 2008
  • The purpose of this study was to investigate the effect of different arthroplasty designs on knee kinematic and lower limb muscular activation for up-stair and down-stair movement. 3-D video analysis of whole body and joint kinematics and EMG analysis of quadriceps and hamstrings were conducted. One-way ANOVAs were used for statistical analyses (p=0.05). The single-radius group exhibited more arthroplasty limb quadriceps EMG and hamstring coactivation EMG than the multi-radius group. Single-radius demonstrated more abduction angular displacement and reached peak abduction earlier than the multi-radius arthroplasty limb. The single- radius the percent body fat showed similar values in the Elderly, Single and Multi-radius group among the periods, however Control group was Lowered among the periods. Single-radius group limb also increased the quadriceps muscle activation level to produce more knee extension moment to compensate for the short quadriceps moment arm. Resting metabolic rate was significantly increased in control group in the period of LI. Energy expenditure was extremely increased in all groups except control group among the periods. We can say this is the exercise effects.

A Study on the Stability and Moisturizing Effect for the Cream Containing Castanea crenata Leaf Extract (밤나무 잎 추출물 함유 크림의 안정성 및 피부 보습효과에 관한 연구 (2))

  • Kim, Jin-Young;Park, Soo-Nam
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.35 no.4
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    • pp.301-307
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    • 2009
  • In the previous study, we evaluated and reported about the anti-oxidative activities of extract/fraction of Castanea crenata leaf. Extract/fraction of Castanea crenata leaf showed excellent free radical scavenging activity, cell protective activity and inhibitory activity on tyrosinase and elastase. In this study, in order to investigate the stability of cream containing 0.2 % Castanea crenata ethyl acetate fraction. pH, viscosity, and absorbance were measured under 4 different temperature ($4^{\circ}C$, $20^{\circ}C$, $37^{\circ}C$, $45^{\circ}C)$ and under the sun light at 2 weeks intervals for the 8 weeks. The variations on pH and viscosity of all experimental creams were similar to control cream. The absorbance variation of extract from experimental cream at 353 nm was in the order: under the sun > $45^{\circ}C$ > $37^{\circ}C$ > $20^{\circ}C$ > $4^{\circ}C$. It shows that ethyl acetate fraction in the cream can be oxidized under the sun. The bad smell and discoloration were not shown. Also, physical changes as creaming and cohesion were not shown. Also, transepidermal water loss (TEWL) and water contents in skin were measured. The cream containing Castanea cranata leaf extract was applied to the right lower arm. After 120 min, TEWL of parts was decreased as 29.7 % (experimental cream) and 5.4 % (control cream) respectively. And the water contents in skin were increased 22.6 % (experimental cream) and 24.7 % (control cream) respectively. It was confirmed that a cream containing ethyl acetate fraction of Castanea crenata leaf shows the superior moisturizing effect. The results showed that Castanea crenata leaf extract could be used as a new active ingredient for anti-aging cosmeceuticals.

The Study on Musculoskeletal Symptoms and it's Related Factors in Radio-Technologists (방사선사의 근골격계 증상과 유해 요인에 관한 연구)

  • Lee, Hyang-Seob;Han, Man-Seok
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.239-247
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    • 2008
  • In order to study the occurrence of symptoms of musculoskeletal disorders of radio-technologists employed at metropolitan general hospitals and the factors that influence such occurrence, standardized questionnaire by NIOSH that was modified and supplemented to be suitable for conditions in Korea was used. Answers collected from 143 radio-technologists in two weeks from June 13, 2007 were analyzed and the results are as follows. Factor that influence symptoms of musculoskeletal disorders by area were analyzed through multiple logistic regression analysis and the results found that in the neck area, risk increased as the burdening work category 2(Korea ministry of labor)(OR=3.94) and burdening work category 9(Korea ministry of labor)(OR=4.72) increased. In the shoulder region, risk increased as burdening work category 2(Korea ministry of labor)(OR=5.36), burdening work category 7(Korea ministry of labor)(OR=3.90), and burdening work category 9 (Korea ministry of labor)(OR=5.76) increased. In the arm/hand/wrist regions, risk increased as burdening work category 2 (Korea ministry of labor) (OR=6.91), and burdening work category 9 (Korea ministry of labor)(OR=3.76) increased. In the lower back region, risk increased as burdening work category 2 (Korea ministry of labor) (OR=3.06), and burdening work category 8 (Korea ministry of labor)(OR=8.14) increased. In the leg/knees/foot regions, risk increased as burdening work category 2 (Korea ministry of labor) (OR=3.63), and burdening work category 9 (Korea ministry of labor)(OR=2.96) increased. Conclusively, in factors that influence musculoskeletal disorder symptoms in radio-technologists, influence of subjective health conditions, total work experience, experience in current division, and burdening work category 2, 7, 8, and 9 (Korea ministry of labor) were most significant. Therefore, for preventive management, in addition to ergonomic and educational intervention for correcting improper posture during work, efforts for break time adjustment and stress reduction is needed, and encouragement and support for regular exercise is needed.

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EMERGY Analysis of Korean Fisheries (한국수산업의 EMERGY 분석)

  • SOHN Ji-Ho;SHIN Sung-Kyo;CHO Eun-Il;LEE Suk-Mo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.29 no.5
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    • pp.689-700
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    • 1996
  • Fisheries products have to be produced and maintained by work processes from the environment, sometimes helped by people. In Korean fisheries both environmental production and its economic use are included within the windows of system approach. EMERGY is the sum of all inputs expressed as one form of solar energy required directly and indirectly to make a product. Calculating EMERGY flows into Korean fisheries evaluates the real wealth contributed by environmental production and its economic use. Several indices calculated from EMERGY analysis table and a three-arm diagram give perspective on the type and efficiency of the environmental uses. Net EMERGY yield ratio is a measure of its net contribution to the economy beyond its own operation. For adjacent waters fisheries in Korea, the net contribution to the economy is 11.85 or higher, which is a stimulus to the economy that is able to purchase it. EMERGY investment ratio measures the intensity of the economic development and the loading of the environment. The ratio for Korean fisheries as a whole is 0.50, for the adjacent waters fisheries 0.09 and for the shallow-sea cultures 1.28, which is lower than the same index for the industry of the developed country (7.0). The component of environment drawn into production are large compared to purchased investment in Korean fisheries. Much more EMERGY is contained in fisheries products than in the paid services used to process the products. The EMERGY exchange ratio for Korean fisheries as a whole is 6.98, for the adjacent waters fisheries is 10.69 and for the shallow-sea cultures is 1.25. Using market values to evaluate wealth of environment resources is found to be many times too small. Money is paid only to people for their contribution, and never to the environment for its contribution. Macroeconomic value is the appropriate measure for discussing large-scale considerations of an economy, including environment and human goods & services.

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Clinical Study of Rhabdomyolysis After Exercise (운동 후 발생한 횡문근 융해증의 임상적 고찰)

  • Ahn, Young-Joon;Yi, Seung-Rim;Yoo, Jae-Ho;Zoo, Min-Hong;Kim, Seong-Wan;Park, Ji-Man;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.110-114
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    • 2007
  • Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

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A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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Anatomy of Spleen Meridian Muscle in human (족태음비경근(足太陰脾經筋)의 해부학적(解剖學的) 고찰(考察))

  • Park Kyoung-Sik
    • Korean Journal of Acupuncture
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    • v.20 no.4
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    • pp.65-75
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    • 2003
  • This study was carried to identify the component of Spleen Meridian Muscle in human, dividing into outer, middle, and inner part. Lower extremity and trunk were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Spleen Meridian Muscle. We obtained the results as follows; 1. Spleen Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle; ext. hallucis longus tend., flex. hallucis longus tend.(Sp-1), abd. hallucis tend., flex. hallucis brevis tend., flex. hallucis longus tend.(Sp-2, 3), ant. tibial m. tend., abd. hallucis, flex. hallucis longus tend.(Sp-4), flex. retinaculum, ant. tibiotalar lig.(Sp-5), flex. digitorum longus m., tibialis post. m.(Sp-6), soleus m., flex. digitorum longus m., tibialis post. m.(Sp-7, 8), gastrocnemius m., soleus m.(Sp-9), vastus medialis m.(Sp-10), sartorius m., vastus medialis m., add. longus m.(Sp-11), inguinal lig., iliopsoas m.(Sp-12), ext. abdominal oblique m. aponeurosis, int. abd. ob. m., transversus abd. m.(Sp-13, 14, 15, 16), ant. serratus m., intercostalis m.(Sp-17), pectoralis major m., pectoralis minor m., intercostalis m.(Sp-18, 19, 20), ant. serratus m., intercostalis m.(Sp-21) 2) Nerve; deep peroneal n. br.(Sp-1), med. plantar br. of post. tibial n.(Sp-2, 3, 4), saphenous n., deep peroneal n. br.(Sp-5), sural cutan. n., tibial. n.(Sp-6, 7, 8), tibial. n.(Sp-9), saphenous br. of femoral n.(Sp-10, 11), femoral n.(Sp-12), subcostal n. cut. br., iliohypogastric n., genitofemoral. n.(Sp-13), 11th. intercostal n. and its cut. br.(Sp-14), 10th. intercostal n. and its cut. br.(Sp-15), long thoracic n. br., 8th. intercostal n. and its cut. br.(Sp-16), long thoracic n. br., 5th. intercostal n. and its cut. br.(Sp-17), long thoracic n. br., 4th. intercostal n. and its cut. br.(Sp-18), long thoracic n. br., 3th. intercostal n. and its cut. br.(Sp-19), long thoracic n. br., 2th. intercostal n. and its cut. br.(Sp-20), long thoracic n. br., 6th. intercostal n. and its cut. br.(Sp-21) 3) Blood vessels; digital a. br. of dorsalis pedis a., post. tibial a. br.(Sp-1), med. plantar br. of post. tibial a.(Sp-2, 3, 4), saphenous vein, Ant. Med. malleolar a.(Sp-5), small saphenous v. br., post. tibial a.(Sp-6, 7), small saphenous v. br., post. tibial a., peroneal a.(Sp-8), post. tibial a.(Sp-9), long saphenose v. br., saphenous br. of femoral a.(Sp-10), deep femoral a. br.(Sp-11), femoral a.(Sp-12), supf. thoracoepigastric v., musculophrenic a.(Sp-16), thoracoepigastric v., lat. thoracic a. and v., 5th epigastric v., deep circumflex iliac a.(Sp-13, 14), supf. epigastric v., subcostal a., lumbar a.(Sp-15), intercostal a. v.(Sp-17), lat. thoracic a. and v., 4th intercostal a. v.(Sp-18), lat. thoracic a. and v., 3th intercostal a. v., axillary v. br.(Sp-19), lat. thoracic a. and v., 2th intercostal a. v., axillary v. br.(Sp-20), thoracoepigastric v., subscapular a. br., 6th intercostal a. v.(Sp-21)

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Antioxidant Activity of Rhododendron brachycarpum D. Don Extracts and Its Skin Hydration Effect Measure (만병초 추출물의 항산화활성과 보습효과 측정)

  • Park, Jung-Ok;Lim, Gyu-Nam;Park, Su-Nam
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.36 no.2
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    • pp.157-165
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    • 2010
  • In this study, the antioxidative effects, inhibitory effects on tyrosinase and elastase of Rhododendron brachycarpum D. Don extracts were investigated. And the moisturizing effect of cream containing R. brachycarpum D. Don extract were investigated by clinical trial. The ethyl acetate fraction of R. brachycarpum D. Don extract (1.83 ${\mu}g/mL$) showed the most prominent the free radical (1,1-diphenyl-2-picrylhydrazyl, DPPH) scavenging activity ($FSC_{50}$). Reactive oxygen species (ROS) scavenging activities ($OSC_{50}$) of R. brachycarpum D. Don extracts on ROS generated in $Fe^{3+}$-EDTA/$H_2O_2$ system were investigated using the luminol-dependent chemiluminescence assay. The 50 % extract fraction (0.064 ${\mu}g/mL$) showed the most prominent ROS scavenging activity. The protective effects of extract/fractions of R. brachycarpum D. Don on the rose-bengal sensitized photohemolysis of human erythrocytes were investigated. The R. brachycarpum D. Don extracts suppressed photohemolysis in a concentration dependent manner (1 ~ 10 ${\mu}g/mL$). The inhibitory effects ($IC_{50}$) of R. brachycarpum D. Don extracts on tyrosinase were determined with ethyl acetate fraction of R. brachycarpum D. Don extract (70.5 ${\mu}g/mL$) and aglycone fraction of extract (122.40 ${\mu}g/mL$). The inhibitory effects ($IC_{50}$) on elastase were determined with ethyl acetate of R. brachycarpum D. Don extract (43.50 ${\mu}g/mL$) and aglycone fraction of extract (20.73 ${\mu}g/mL$). The cream containing the ethyl acetate fraction of R. brachycarpum D. Don extracts was formulated for skin hydration effect and transepidermal water loss (TEWL). The cream containing R. brachycarpum D. Don extract was applied to the right lower arm. After 180 min, the water contents in skin were increased by 1 ~ 4 % than the placebo cream. And TEWL of parts was decreased as 7.7 $g/m^2h$ (experimental cream) and 8.9 $g/m^2h$ (placebo cream) respectively. These results indicate that extract/fractions of R. brachycarpum D. Don can function as antioxidants in biological systems, particularly skin exposed to UV radiation by scavenging $^1O_2$ and other ROS, and protect cellular membranes against ROS. And inhibitory activity on tyrosinase of the aglycone fraction could be applicable to new functional cosmetics for whitening and anti-wrinkle products. Also the increase of skin hydration of the cream containing extract could be applicable to new functional cosmetics for antiaging.

Customer Acceptance Procedure for Clinac (21EX-Platinum)

  • Hong, Dong-Ki;Lee, Woo-Seok;Kwon, Kyung-Tae;Park, Kwang-Ho;Kim, Chung-Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.43-61
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    • 2004
  • Purpose : For qualify improvement in radiotherapy, it is important to set up and evaluate equipment (linac) accurately. In addition, technicians are needed to be fully aware of the equipment's detailed quality and its manual. Therefore, the result of ATP is evaluated and introduced, in order that the technicians are skilled by participating in quality assurance (QA) and understanding the quality of the equipment before clinical use. Method and Material : QA for LINAC 21EX (Varian, US) was done with suppliers its procedure was divided into radiation survey, mechanical test, radiation isocenter test, bean performance, dosimetry, and enhanced dynamic wedge and using X-omat film (Kodak), multidata, densitometer, and electrometer. QA of MLC (Millennium, 120 leaf) attached to LINAC and EPID (Portal vision) were done separately. Result : The leakage dose by survey meter was below the tolerance. In mechanical test, collimater, gantry, and couch rotation were less than 1mm, and the angles were ${\pm}0.1^{\circ}$ for digital and ${\pm}0.5^{\circ}$ for mechanical. The alignment test of the light field and crosshair were evaluated less than 1mm. The (a)symmetrical jaw field was less than ${\pm}0.5mm$. The radiation isocenter test using X-mat film was less than 1mm. The consistency of light field and radiation field was less than ${\pm}0.1mm$. PDD for photon energy was less than ${\pm}1\%$ and for electron energy of $90\%,\;80\%,\;50\%,\;and\;30\%$ were evaluated within the tolerance. Flatness for photon and electron energy was evaluated $2.3\%$ (tolerance $3\%$) and $3\%$ (tolerance $4.5\%$), respectively, and symmetry was $0.45\%$ (tolerance $2\%$) and $0.3\%$ (tolerance $2\%$), respectively. Dosimetry test for short term, MU setting, rep rate, and dose rate accuracy of photon and electron energy was within the tolerance depending on energy, MU, and gantry angle. Conclusion : Accuracy and safety for clinical use of Clinac 21EX was verified through customer acceptance procedure and the quality of the equipment was found out. These can reduce the difficulties in using the equipment. Furthermore, it is useful for clinically treatment of patients by technicians' active participations.

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