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Evaluation on Organ Dose and Image Quality of Lumbar Spine Radiography Using Glass Dosimeter (유리선량계를 이용한 요추검사의 장기선량 및 영상의 평가)

  • Kim, Jae-Kyeom;Kim, Jeong-Koo
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.1-11
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    • 2016
  • The purpose of this study was to provide resources for medical exposure reduction through evaluation of organ dose and image resolution for lumbar spine around according to the size of the collimator in DR system. The size of the collimator were varied from $8^{\prime\prime}{\times}17^{\prime\prime}$ to $14^{\prime\prime}{\times}17^{\prime\prime}$ by 1" in AP and lateral projection for the lumbar spine radiography with RANDO phantom. The organ dose measured for liver, stomach, pancreas, kidney and gonad by the glass dosimeter. The image resolution was analyzed using the Image J program. The organ dose of around lumbar spine were reduced as the size of the collimator is decreased in AP projection. There were no significant changes decreasing rate whenever the size of the collimator were reduced 1" in the gonad. The organ dose showed higher on liver and kidney near the surface in lateral projection. There were decreasing rate of less than 5% in liver and kidney, but decreasing rate was 24.34% in the gonad whenever the size of the collimator were reduced 1". Organ dose difference for internal and external of collimator measured $549.8{\mu}Gy$ in the liver and $264.6{\mu}Gy$ in the stomach. There were no significant changes organ dose difference that measured $1,135.1{\mu}Gy$ in the gonad. Image Quality made no difference because SNR and PSNR were over than 30 dB when the collimator size is less than $9^{\prime\prime}{\times}17^{\prime\prime}$ on AP projection and $10^{\prime\prime}{\times}17^{\prime\prime}$ on lateral projection. Therefore, we are considered that the recommendations criterion for control of collimator were suggested in order to reduce unnecessary X-ray exposure and to obtain good image quality because lumbar spine radiography contains a lot of peripheral organs rather than other area radiography.

Radiation Therapy for Pituitary Adenoma -Changes in Endocrine Function after Treatment- (뇌하수체선종의 방사선치료후 혈중 호르몬치의 변화)

  • Yoon Sei Chul;Jang Hong Suck;Kim Song Hwan;Shinn Kyung Sub;Bahk Yong Whee;Son Ho Young;Kang Joon Ki
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.185-195
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    • 1991
  • Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.

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Intraluminal High-Dose-Rate Brachytherapy for the Tumors of Gastrointestinal Tract (위장관 종양의 고선량율 강내 방사선치료)

  • Choi Byung Ock;Choi Ihl Bhong;Chung Su Mi;Kim In Ah;Choi Myoung Gyu;Chang Suk Kyun;Shinn Kyeong Sub
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.243-252
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    • 1995
  • Purpose : Intraluminal high dose rate brachytherapy is an accepted treatment for the tumors of GI tract. However, there is only some limited clinical data for intraluminal high dose rate brachytherapy for the tumors of GI tract. Materials and Methods : Between February 1991 and July 1993, 18 Patients who have the tumors of GI tract (esophageal cancer-8 cases, rectal cancer-10 cases) were treated with high dose rate Iridium-192 afterloading system (Microselectron-HDR, Nucletron CO, Netherland) at the department of therapeutic radiology, St. Mary's hospital, Catholic university medical college. Age range was 47-87 years with a mean a9e 71 years. All patients were treated with intraluminal high dose rate brachytherapy within two weeks after conventional external radiation therapy and received 3-5 Gy/fraction 3-4 times per week to a total dose 12-20 Gy (mean 17 Gy). Standard fractionation and conventional dose were delivered for external radiation therapy. Total dose of external radiation therapy ranged 41.4-59.4 Gy (mean 49.6 Gy). Median follow up was 19 months Results : The analysis was based on 18 patients, The complete response and partial response in esophageal cancer was similar (38%). Two year rates for survival and median survival were 13% and 10 months, respectively. Among 10 patients of rectal cancers, partial response was obtained in 6 patients (60%). There was no complete response in the patients with rectal cancer, but good palliative results were achieved in all patients. Conclusion : Although the number of patients was not large and the follow-up period was relatively short, these findings suggested that intraluminal high dose rate brachytherapy could be useful in the treatment of the patients with advanced tumors of GI tract.

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Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea

  • Song, Jason Jungsik;Song, Yeong Wook;Bae, Sang Cheol;Cha, Hoon-Suk;Choe, Jung-Yoon;Choi, Sung Jae;Kim, Hyun Ah;Kim, Jinseok;Kim, Sung-Soo;Lee, Choong-Ki;Lee, Jisoo;Lee, Sang-Heon;Lee, Shin-Seok;Lee, Soo-Kon;Lee, Sung Won;Park, Sung-Hwan;Park, Won;Shim, Seung Cheol;Suh, Chang-Hee;Yoo, Bin;Yoo, Dae-Hyun;Yoo, Wan-Hee
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.346.1-346.11
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    • 2018
  • Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

Influences of role conflict, workload, secondary traumatic stress and self-efficacy on burnout of social workers working with trauma survivors (외상생존자와 일하는 사회복지사의 소진에 대한 역할갈등, 업무부담과 이차적 외상 스트레스 및 자기효능감의 영향)

  • Park, Yun-Mi;Yoon, Hyemee
    • Journal of the Korean Society of Child Welfare
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    • no.36
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    • pp.289-322
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    • 2011
  • The purpose of this study is to examine the relationship between job characteristics such as role conflict, workload, and self-efficacy, secondary traumatic stress(STS), and burnout of social-workers who are working with survivors of child abuse, spouse abuse and sexual assault. While burnout has been studied over two decades all over the world, secondary traumatic stress(STS) is a less familiar term in the field of social work. Studies explaining the relationship between job-demands, STS, and burnout for social workers working with violence victims lack integrative insights across agencies serving children and adults. Thus, we examine whether the relationships between change based on wheter the survivor is a child or an adult. Two hundred thirty three social workers in Korea who work with violence victims participated in the survey. The data were analyzed with Amos 7.0. Results indicate that STS plays a key role in explaining social worker burnout across the agencies, and Child Protective Service workers were found to have the highest STS symptoms. The pathways to social worker burnout proved to be different based on who you served. Theoretical and practical implications of these findings were discussed.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Isolation and characterization of cellulolytic yeast belonging to Moesziomyces sp. from the gut of Grasshopper (메뚜기의 내장에서 분리한 Moesziomyces 속에 속하는 셀룰로오스 분해 효모의 분리 및 특성)

  • Kim, Ju-Young;Jung, Hee-Young;Park, Jong-Seok;Cho, Sung-Jin;Lee, Hoon Bok;Sung, Gi-Ho;Subramani, Gayathri;Kim, Myung Kyum
    • Korean Journal of Microbiology
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    • v.55 no.3
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    • pp.234-241
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    • 2019
  • An intensive interaction between yeasts and insects has highlighted their relevance for attraction to food and for the insect's development and behavior. Yeast associated in the gut of insects secretes cellulase which aided in the food digestion (cellulose degradation). Three strains of cellulose-degrading yeast were isolated from the gut of adult grasshoppers collected in Gyeonggi Province, South Korea. The strains $ON22^T$, $G10^T$, and $G15^T$, showed positive cellulolytic activity in the carboxymethyl cellulose (CMC)-plate assay. The phylogenetic tree based on sequence analysis of D1/D2 domains of the large subunit rRNA gene and the internal transcribed spacer (ITS) regions revealed that the strains $ON22^T$ (100 and 98.4% sequence similarities in D1/D2 domains and ITS) and $G10^T$ (99.8 and 99.5% in D1/D2 domain and ITS region) were most closely related to the species Moesziomyces aphidis JCM $10318^T$; $G15^T$ (100% in D1/D2 domains and ITS) belongs to the species Moesziomyces antarcticus JCM $10317^T$, respectively. Morphology and biochemical test results are provided in the species description. Cellulase with its massive applicability has been used in various industrial processes such as biofuels like bioethanol productions. Therefore, this is the first report of the cellulolytic yeast strains $ON22^T$, $G10^T$, and $G15^T$ related to the genus Moesziomyces in the family Ustilaginaceae (Ustilaginales), in Korea.

Effects of environmental enrichments on performance and behavior characteristics of sows during gestating period (환경보조물이 임신모돈의 생산성 및 행동특성에 미치는 영향)

  • Jeong, Yong-Dae;Kim, Doo-Wan;Min, Ye-Jin;Jung, Hyun-Jung;Cho, Eun-Seok;Kim, Young-Hwa
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.428-434
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    • 2019
  • Many countries have interested animal welfare. Similarly, domestic people have concern for the welfare from companion animals to livestock. Environmental enrichments (EE) are tool to enforce the welfare, however, research with sows is limited. Therefore, this study was investigate to effects of environmental enrichments on performance and behavior properties of gestating sows. A total of 30 pregnant sows (Landrace) were assigned into three treatments that control, T1 (plastic device) and T2 (Rice straw). Period of trial was from Mar. 03. 18. to Mary 19. 18. The EE were allotted to center of experimental pen ($11.6{\times}6.0m$). Body weight (BW), backfat thickness (BF) and cortisol were identified at experimental initial or end date. Behavior was recorded during 24 hours on days 91 of gestation, and then analyzed the patterns. BF was reduced (15.73 vs. 16.56 mm; p>0.05) in T1 than control, but Ending BW, total litter size and alive piglets did not differ. Born dead piglets showed lower tendency (1.00 and 0.63 vs. 1.50 heads; p>0.05) in T1 and T2 than control. Similarly, the enrichments declined farrowing mortality (C, 8.68%; T1, 6.86%; T2, 3.40%; p>0.05). Cortisol was not differed among treatments. In the behavior characteristics, eating showed lower (1.81 vs. 9.68 and 6.99%; p<0.05) in T2 than control and T1. Furthermore, playing or digging were only observed (0.33 and 2.10%; p<0.05) in T1 and T2, respectively, whereas rubbing (0.91%, p<0.05) only showed in the control. These results suggest that the provision of EE would be not negatively affected the performance of the gestating sows and could be led to improvement of the livestock welfare.

Multi-Institute, Single Group, Prospective Observational Study to Evaluate the Efficacy of Mucomyst® in Relieving Symptoms of Globus Pharyngeus Refractory to Proton Pump Inhibitor (양성자펌프억제제에 반응하지 않는 인두이물감 환자에서 "뮤코미스트Mucomyst®" 객담제거 및 상기도 염증치료를 통한 증상개선효과 평가 다기관, 단일군, 전향적 관찰 연구)

  • Park, Hannah;Park, Il-Seok;Lee, Sang Hyuk;Lee, Seung-Won;Lee, Sang Joon;Lee, Byung-Joo;Cheon, Yong-Il;Park, Jun-Ook;Oh, Kyoung Ho;Shin, Yoo Seob
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.20-25
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    • 2022
  • Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.

Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study

  • Choi, Seohee;Min, Jae-Seok;Jeong, Sang-Ho;Yoo, Moon-Won;Son, Young-Gil;Oh, Sung Jin;Kim, Jong-Han;Park, Joong-Min;Hur, Hoon;Jee, Ye Seob;Hwang, Sun-Hwi;Jin, Sung-Ho;Lee, Sang Eok;Lee, Young-Joon;Seo, Kyung Won;Park, Sungsoo;Lee, Chang Min;Kim, Chang Hyun;Jeong, In Ho;Lee, Han Hong;Choi, Sung Il;Lee, Sang-Il;Kim, Chan-Young;Chae, Hyundong;Son, Myoung-Won;Pak, Kyung Ho;Kim, Sungsoo;Lee, Moon-Soo;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.67-77
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    • 2022
  • Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years. Materials and Methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group. Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072-3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550-5.692; P=0.001). Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.