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Evaluation of useful treatment which uses dual-energy when curing lung-cancer patient with stereotactic body radiation therapy (폐암 환자의 정위적방사선 치료 시 이중 에너지를 이용한 치료 방법의 유용성 평가)

  • Jang, Hyeong Jun;Lee, Yeong Gyu;Kim, Yeong Jae;Park, Yeong Gyu
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.87-99
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    • 2016
  • Purpose : This study will evaluate the clinical utility by applying clinical schematic that uses monoenergy or dual energy as according to the location of tumors to the stereotactic radiotherapy to compare the change in actual dose given to the real tumor and the dose that locates adjacent to the tumor. Materials and Methods : CT images from a total of 10 patients were obtained and the clinical planning were planned based on the volumetric modulated arc therapy on monoenergy and dual energy. To analyze the change factor in the tumor, Comformity Index(CI) and Homogeneity Index(HI) and maximum dose quantity were each calculated and comparing the dose distribution on normal tissues, $V_{10}$ and $V_5$, first ~ fourth ribs closest to the tumor ($1^{st}{\sim}4^{th}$ Rib), Spinal Cord, Esophagus and Trachea were selected. Also, in order to confirm the accuracy on which the planned dose distribution is really measured, the 2-dimensional ion chamber array was used to measure the dose distribution. Results : As of the tumor factor, CI and HI showed a number close to 1 when the two energies were used. As of the maximum dose, the front chest wall showed 2% and the dorsal tumor showed equivalent value. As of normal tissue, the front chest wall tumors were reduced by 4%, 5% when both energies were used in the adjacent rib and as of trachea, reduced by 11%, 17%. As of the dose in the lung, as of $V_{10}$, it reduced by 1.5%, $V_5$ by 1%. As of the rear chest wall, when both energies were used, the ribs adjacent to the tumors showed 6%, 1%, 4%, 12% reduction, and in the lung dose distribution, $V_{10}$ reduced by 3%, and $V_5$ reduced by 3.1%. The dose measurement in all energies were in accordance to the results of Gamma Index 3mm/3%. Conclusion : It is considered that rather than using monoenergy, utilizing double energy in the clinical setting can be more effectively applied to the superficial tumors.

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The Efficacy of Proximal Esophageal 24-hour pH Monitoring in Infants with Chronic Cough (만성기침을 동반한 영아에서 상부 식도 24시간 pH 검사의 유용성)

  • Kim, Yun Hee;Kim, Ja Kyoung;Kim, Jung Hee;Lim, Dae Hyun;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1242-1247
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    • 2003
  • Purpose : Gastroesophageal reflux disease(GERD) is known as one of the most common causes of chronic cough, especially in children. The purpose of this study is to evaluate the efficacy of parameters from proximal esophageal 24-hr pH monitoring through its comparison with those of distal esophageal 24-hr pH monitoring that we generally use for diagnosis of GERD. Methods : We performed chest CT scans to find out the cause of chronic cough in infants with no clinical manifestation suggesting GERD. Then, in case that they had air space consolidation in posterior segment of both upper lobes and superior segment of both lower lobes(dependent position), we performed proximal and distal esophageal 24-hr pH monitoring. Results : The proximal and distal pH monitoring were performed in 17 infants(male 12; female five). The patients with positive pathologic reflux in proximal esophagus were 15 of 17(88.2%) and in distal esophagus were four of 17(23.5%). Reflux index and the total number of reflux episodes were statistically significantly lower in the proximal than in the distal esophagus(P<0.05). There was no correlation between each parameters of proximal and distal esophageal 24-hr pH monitoring. Conclusion : This study suggests that proximal esophageal 24-hr pH monitoring can be used as a very useful diagnostic tool in infants with chronic cough in which there are suspicions that it resulted from aspiration due to GERD.

A SURVEY OF SEDATION PRACTICES IN THE KOREAN PEDIATRIC DENTAL OFFICE (어린이의 치과치료시 약물에 의한 진정요법 사용에 대한 실태조사)

  • An, So-Youn;Choi, Byung-Jai;Kwak, Ji-Youn;Kang, Jeong-Wan;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.444-453
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    • 2005
  • Sometimes the dentists encounter a child who can not be treated with traditional behavior management techniques (for example, reward, restraint, Tell-Show-Do, familialization). In such a case, the dentists use sedation technique. Recently, in Korea, the use of sedation by pediatric dentists is increased. But, the guideline and survey of sedation is very insufficient. Now, we need a survey of sedation practice in Korea. We carried out research on the actual condition about sedation with a questionaire to pediatric dentists in Korea. Followings are the conclusions 1. Sixty six percent of pediatric dentists use sedative agents in their practice. In this study, using sedation shows an increase as compared with the past. 2. Determinative factors of using sedation were orderly behavior management, number of visiting, guidian's opinion, amount of treatment, general condition. 3. Distribution of ages in patients sedated with agents was orderly 3 years, 4-5 years, under 2 years, 6-10 years, more than 10 years. 4. Particular sedative drugs were chloral hydrate 60-70mg/kg, hydroxyzine 10-40mg/kg(25mg/kg), and oral route was the most favorable route. 5. Observation of skin and nail color, pulse oximeter were the most frequently utillized monitoring method during sedation. 6. Only fifty six percent of pediatric dentists complete the cardiopulmonary resuscitation course.

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A Study on Titanium Miniscrew as Orthodontic Anchorage : An experimental investigation in dogs (성견에서 교정적 고정원으로서의 티타늄 미니스크류에 대한 연구)

  • Yoon, Byung-Soo;Choi, Byung-Ho;Lee, Won-You;Kim, Kyoung-Nam;Shim, Hyung-Bo;Park, Jin-Hyung
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.517-523
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    • 2001
  • Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.

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Evaluation of Reliability about Short TAT (Turn-Around Time) of Domestic Automation Equipment (Gamma Pro) (국산 자동화 장비(Gamma Pro)의 결과보고시간 단축에 대한 유용성 평가)

  • Oh, Yun-Jeong;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.197-202
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    • 2010
  • Purpose: Recently, many hospitals have been tried to increase the satisfaction of the outpatients through blood-gathering, exam, result notice and process in a day. Each laboratory has been used the automatic equipment for the rapid requests of the result notice and the increase of the reliability and efficiency. Current automatic equipments that have been limited short TAT(Turn-Around Time)because of the restricted batch lists and 1 tip-5 detectors. The Gamma Pro which is made in Korea to improve the shortcomings of existing automation equipment, complemented with capacity to perform a wide range of domestic automation equipment. In this study, we evaluated the usefulness and reliability of short TAT by comparing Gamma Pro with current automatic equipment. Materials and Methods: We studied the correlation between Gamma Pro and RIA-mat 280 using the respective 100 specimens of low or high density to the patients who were requested the thyroid hormone test (Total T3, TSH and Free T4) in Samsung Medical Center Sep. 2009. To evaluate the split-level Gamma Pro, First, we measured accuracy and carry over on the tips. Second, the condition of optimal incubation was measured by the RPM (Revolution Per Minute) and revolution axis diameter on the incubator. For the analysis for the speed of the specimen-processing, TAT was investigated with the results in a certain time. Result: The correlation coefficients (R2) between the Gamma Pro and RIA-mat 280 showed a good correlation as T3 (0.98), TSH (0.99), FT4 (0.92). The coefficient of variation (C.V) and accuracy was 0.38 % and 98.3 % at tip 1 and 0.39 % and 98.6 % at tip 2. Carry over showed 0.80 % and 1.04% at tip 1 and tip 2, respectively. These results indicate that tips had no effect on carry over contamination. At the incubator condition, we found that the optimal condition was 1.0mm of diameter at 600RPM in 1.0mm and 1.5mm of at 500RPM or 1.0mm and 1.5 mm of diameter at 600 RPM. the Gamma Pro showed that the number of exam times were increased as maximum 20 times/day comparing to 6 times/day by current automatic equipment. These results also led to the short TAT from 4.20 hour to 2.19 hours in whole processing. Conclusion: The correlation of between the Gamma Pro and RIA-mat 280 was good and has not carry over contamination in tips. The domestic automation equipment (Gamma Pro) decreases the TAT in whole test comparing to RIA-280. These results demonstrate that Gamma Pro has a good efficiency, reliability and practical usefulness, which may contribute to the excellent skill to process the large scale specimens.

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Vitamin D and Risk of Respiratory Tract Infections in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials (비타민 D와 소아 호흡기 감염의 위험성: 무작위 대조 연구에 대한 체계적 문헌고찰 및 메타분석)

  • Ahn, Jong Gyun;Lee, Dokyung;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.23 no.2
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    • pp.109-116
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    • 2016
  • Purpose: Recent observational studies have found that vitamin D deficiency is associated with respiratory tract infections. However, randomized controlled trials (RCTs) regarding the efficacy of vitamin D in childhood respiratory tract infection (RTI) have yield inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between vitamin D supplementation and the risk of RTI. Methods: A comprehensive search was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trial. Randomized controlled trials of vitamin D supplementation for prevention of RTI in children were included for the analysis. Cochrane Collaboration's tool for assessing the risk of bias was used to assess the quality of the studies. Pooled risk ratios with 95% confidence intervals (CIs) were meta-analyzed using Review Manager 5.3. Results: A total of seven RCTs were included in the meta-analysis. According to a random-effects model, the risk ratio for vitamin D supplementation was 0.82 (95% CI: 0.69-0.98) and $I^2=62%$ for heterogeneity. On subgroup analysis, heterogeneity decreased in the subgroup with follow-up less than 1 year, participants ${\geq}5years$ of age, patients subgroup, and subgroup with dosing daily. Funnel plot showed that there might be publication bias in the field. Conclusions: The present meta-analysis supports a beneficial effect of vitamin D supplementation for the prevention of RTI in children. However, the result should be interpreted with caution due to limitations including a small number of available RCTs, heterogeneity among the studies, and potential publication bias.

Characterization and Distribution of Glycoconjugates in Human Pulmonary Tubercles by Lectin Histochemistry (폐결핵 결절에서 복합당질의 분포에 관한 Lectin 조직화학적 연구)

  • Yoon, Sik;Kim, Ji-Hong;Shin, Cheol-Shik;Jeong, Suk;Son, Mal-Hyun;Song, Sun-Dae;Kim, Jin-Jeong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.3
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    • pp.248-261
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    • 1994
  • Background: Lectins are proteins or glycoproteins of non-immune origin that recognize a specific sequence of sugar residues. The availability of a large number of lectins has provided the capacity to identify selectively glycoconjugates possessing distinctive chemical structure in diverse sites of highly specialized biological activity. The purpose of the present study was to investigate the lectin binding patterns of various components in human pulmonary tubercles. Method: Biopsy specimens of tuberculous lung were obtained from male adult patients who underwent a surgical resection for severe pulmonary tuberculosis. The specimens were processed and stained with 13 kinds of biotinylated lectins according to some modification of Hsu and Raine's methods. Results: 1) In the caseous necrotic lesions, BS $I-B_4$ showed negative reaction and BS I were also negative except some irregularly-shaped cells located in the marginal zone. All other lectins, however, showed a positive reaction with various binding patterns. 2) The epithelioid cells were broadly divided into three groups according to the reaction patterns in the cytoplasms and cell membranes. 3) WGA, ECL, PHA-L, PHA-E and LCA showed strong staining in the lymphocytes. 4) SBA showed a different binding patterns between the endothelial layers located in the region beyond the fibrous layers and those located within the fibrous layers. 5) PNA showed a positive reaction in the outer 1/3 to 1/2 of the fibrous layer, but showed no staining in the inner 1/2 to 2/3 of the fibrous layers. Conclusion: The present lectin histochemical study provided a useful information to assess the characterization and distribution of various glycoconjugates in each constituent of human pulmonary tubercles. The results demonstrate structural differences in the glycoconjugate composition of various components of the tubercles and reveal changes in glycosylation in the components during soft tubercle formation. This study provides a new data useful for the studies on the pathogenesis and pathology of human pulmonary tubercles.

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Prevalence and Risk Factors of Gallstones in Adult Health Screening Population (건강한 성인의 담석 유병률과 위험인자)

  • Lee, Mi-Hwa;Kwon, Duck-Moon;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.287-294
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    • 2014
  • Gallstone is the most common disease of the biliary system. Korean has experienced an increase in the percentage of cholesterol gallstones. The major risk factors associated with cholesterol gallstones are age, gender as well as obesity. This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. The study population consisted of 2,484 males and 2,212 females who visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. Classified as underweight, normal weight or overweight using the population of obese according to the body mass index, and classified according to mood diagnosis of diabetes presented by the American Diabetes Association. Fasting blood glucose and number of liver function, the divided the control group by referring to the normal liver function values used herein. The geological map, I was classified as NCEP APT III. A showed of total 148 people were found to have gallstones. The prevalence of sex among 148 patients (3.15%) 84 men (1.79%) and 64 women 1.36%) which shows significantly there is little difference. 1.84% 40 years and below, 3.38% 40's showed age prevalence was 4.66% in 50's and above. In addition, Total-cholesterol was at the most in 52 people, LDL-cholesterol in 398 people, Triglyceride in 36 people, HDL-cholesterol in 19 people. The abnormal group, was created from the total-cholesterol categories from a physical examination of a subject that has been found to be gallstones in the gallbladder. A result of conducting the univariate analysis shows the prevalence of gallstones, a correlation that is meaningful. The logistic regression analysis of multiple ages was chosen to show risk factors age independent cholelithiasis. In spite of the conclusion, gallstones are not displayed in relation to the metabolic syndrome but in order to clarify this, not only the subject of a health examination is needed but, a further study of the general public when possible.

Clinical study on the comparison of gold and zirconia wear in an implant-supported fixed prosthesis (임플란트 지지 고정성 보철물에서 금과 지르코니아의 마모 비교에 대한 임상 연구)

  • Kim, Jee-Hwan;Yang, Seung-Won;Oh, NamSik
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.4
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    • pp.252-259
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    • 2017
  • Purpose: The purpose of this study was to compare and analyze the wear of a prosthesis for 6 months after restoration with implant-supported fixed dental prosthesis made of either zirconia or gold. Materials and Methods: This study was conducted on patients requiring implant-supported fixed dental prostheses on first or second molar from January, 2015 to January, 2016. A total of 47 prostheses and antagonists were examined. Occlusal surface was recorded by impression of each prosthesis and antagonist 1 week and 6 months after prosthesis delivery. The digital files were created by impression scan. Occlusal shapes of 1 week and 6 months were compared and wear of prostheses and antagonists was analyzed. The Mann-Whitney test was used to analyzed the result data underwent normality test using SPSS (Version 23.0, IBM Corporation) Results: Mann-Whitney test revealed that there was no statistically significant difference in the median amount of mean vertical wear for 6 months in zirconia ($50.84{\mu}m$) and gold ($42.84{\mu}m$) prostheses (P > 0.05). When the opposing teeth were natural, the median amount of mean vertical wear of zirconia and gold prostheses was $47.72{\mu}m$ and $41.97{\mu}m$, respectively, and the median amount of mean vertical wear of enamel was $47.26{\mu}m$ and $44.59{\mu}m$, respectively. Statistical analysis showed no significant difference (P > 0.05). Conclusion: Despite the short study period and the small number of experimental groups, zirconia and gold showed no significant difference in wear during the first 6 months. Opposing natural enamel also showed no significant difference in the wear.

A Study on Actual Conditions for Prevention of Infections by Dental Hygienists (치과위생사의 감염 예방 실태 조사)

  • Nam, Young-Shin;Yoo, Jung-Sook;Park, Myung-Suk
    • Journal of dental hygiene science
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    • v.7 no.1
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    • pp.1-7
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    • 2007
  • This study aimed to provide basic information on dental hygienists' practicing the prevention of infections by figuring out their actual conditions in dental clinics. The subjects of the study were the dental hygienists who participated in the continuing medical education of Incheon & Gyeonggi-do association and Seoul city association in October and November 2005 and the self-administered surveys were used for the prevention of infections. The results were as below. 1. In terms of education experiences of infection prevention, those who answered "there were" were 72 persons (42.9%) and those who followed the educational route for infection prevention were "through the in-house education from the hospital" and they were 42 persons (58%), which were highest. 2. In terms of the injury experiences, those who answered "there were" were 147 persons (87.5%) and the number of annual injury out of 147 persons with injury experiences was 7.7 time. For the tools that were damaged, 125 persons (75%) damaged the "explorer," which was highest. 3. For the experiences of being infected with contagious diseases, those who answered "there were" were 6 persons (3.6%) and there were four persons for "hepatitis B", one person for "rubella" and one person for "TB." 4. The questions with high practice scores were as in the following: "2. I wash my hands after conducting medical examinations (1.86 points)," "7. I always close the lid of a shot of Novocain after doing local anesthesia (1.86 points)" and "20. I separate and collect the wastes and give them to those who treat accumulated materials (1.85 points)". Meanwhile, the questions with low practice scores were as below: "16. I change my medical gowns (doctor wears) once a day (0.24 point)" and "I wash my medical gowns every time after examining patients with contagious diseases (0.52 points)." 5. The question with high knowledge was as below: "1. The contagion during the dental treatment is determined by source of infection, infection methods, infection routes and the host that is prone to infection (0.95 point)" and the question with the lowest knowledge was "5. HBV(hepatitis B) is destroyed after adding 95oC of heat for more than 5 minutes (0.27 points)." 6. The question with the highest organization-related factors was "I am always ready to use a mask, gloves, etc. if necessary" (0.89 points)" and the question with the lowest score was "There is a guideline that I can refer when I am exposed to dangerous situations related to the contagion in my workplace (0.33 point)." 7. In terms of the equipment conditions of protectors in medical environments, 168 persons for (disposable) mask (100%), 167 persons for disposable gloves (Latex) (99.4%), which meant that most of them were equipped with them. On the contrary, 108 persons (64.3%) are equipped with the protectors for frontal faces, which is the lowest and 165 persons (98.2%) said that they had autoclave in their disinfecting and sterilizing devices.

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