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High-Dose-Rate Intraluminal Brachytherapy for Biliary Obstruction by Secondary Malignant Biliary Tumors (속발성 담도부 종양에 의한 담도 폐쇄에서 고선량률 관내 근접치료)

  • Yoon Won-Sup;Kim Tae-Hyun;Yang Dae-Sik;Choi Myung-Sun;Kim Chul-Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.35-43
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    • 2003
  • Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

Study on "Four Tantras", the Prime Textbook of Tibetan Medicine (티벳의학에 대한 연구 - "사부의전(四部醫典).근본의전(根本醫典)"을 중심으로)

  • Chang, Eun-Young;Yun, Chang-Yul
    • Journal of Korean Medical classics
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    • v.11 no.1
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    • pp.416-512
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    • 1998
  • The following conclusions are obtained from the studies on the chapters concerning phisiology, pathology, daily conduct, materia medica, pulse, and urinalysis from , of the "Four Tantras". 1. The theoretical basis forming the Tibetan Medicine is the substance of phlegm, bile, and wind each of which is divided into five kinds. These phisiological substances can be transformed into pathological factors when certain environment is formed. 2. In embryology, the semen of the father and menstral blood of mother is considered the most important condition in conception, and the Five factors are regarded as important. There is a detailed explanation of development of the fetus while it stays in the womb of mother during 38weeks, such as the formation of the viscera, channels, sense organs, etc. 3. There is metaphor which compares the human body with the king's palace. With the development of human anatomy, there is the detailed anatomical picture of anterior and posterior aspects of human body. And also there is the measurement of physiological constitution and the three fluids. 4. In division of the channels, they concerned the now of the blood and distribution of the nerve fibers, and each channel is connected with one another. The division of the cannel is namely embryonic channel, channel of existence, channel of connection, and the course of life principle. 5. The seven bodily constituents and three factors of phlegm, bile, and wind are important in sustaining the life of human body as well as growth and maturization, and when their equilibrium is broken, the human body is degnerated, and finally death comes. 6. The signs of death is divided into distant sign, remote sign, certain sign. and uncertain sign, and is used as a clue in diagnosis of the disease. Especially there is a mention about the mechanism of the dreams, and different dreams according to the condition of the patient. 7. In pathology, there is the cause of the disease, the environmental factors which can induce disease, the path by which disease come into the human body, the characteristics of the disease, and the kinds of disease. 8. There is a mention about the conduct, and it is divided into the daily conduct, the mental attitude, and the side-effects which can occur when one puts up with the physiological actions of the body. 9. The daily diet is divided into food and beverage. The food is divided again into grain, meat, fat, boiled food, and spiced food, and the beverage into milk, water, and wine. 10. The pulsation should be taken in lift hand to diagnose heart, small intestine, stomach, spleen, kidney, reproductive organ, and in right hand jungs, large intestine, liver, gall bladder, kidney, and bladder. In the healthy person, the pulse moves 5times in one perspiration, and the type of pulse is constant while the pulse moves 100times. But unhealthy person's pulse is different from this. The urinalysis is the unique part of Tibetan Medicine, and is important in examination of the disease. One should decide which of the three factors are dominant by the obervation of the color, amount of the steam and how long it lasts, odour, foam, and the shape of the swirl in three different states when the urine is hot, warm, and cold. One can determine the life of the patient and which viscera is the cause of the disease by the pulse, and whether the nature of the disease is hot or cold by the urinalysis. 11. The materia medica contains gemstones, minerals, plateau medication, and meat products.

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The vertical location of the center of resistance for maxillary six anterior teeth during retraction using three dimensional finite element analysis (상악 6전치부의 후방견인시 저항중심의 수직적 위치에 관한 3차원 유한요소법적 연구)

  • Lee, Hye-Kyoung;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.31 no.4 s.87
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    • pp.425-438
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    • 2001
  • The delivery of optimal orthodontic treatment is greatly influenced by clinician's ability to predict and control tooth movement by applying well-known force system to dentition. It is very important to determine the location of the centers of resistance of a tooth or teeth in order to have better understanding the nature of displacement characteristics under various force levels. In this study, three dimensional finite element analysis was used to measure the initial displacement of the consolidated teeth under loading. The purpose of this study was to define the location of the centers of resistance at the upper six anterior segment. To observe the changes of six anterior segment, 200gm, 250gm, 300gm, and 350gm forces at right and left hand side each were imposed toward lingual direction. For this study, two cases, six anterior teeth and six anterior teeth after corticotomy, were reviewed. In addition, it was reviewed the effects of changes on the location of the center of resistance in both cases based on different degree of forces aforementioned. The results were that : 1. The instantaneous center of resistance for the six anterior teeth was vertically located between level 4 and level 5, which is, at 6.76mm, $44.32\%$ apical to the cementoenamel junction level. 2. The instantaneous center of resistance for the six anterior teeth after corticotomy was located vertically between level 4 and level 5, that is, at 7.09mm $46.38\%$ apical to the cementoenamel junction level. 3. Changes of force showed little effect on the location of the center of resistance in each case. 4. It was observed that the location of the instantaneous center of resistance for the six anterior teeth after corticotomy was changed more than the six anterior teeth without corticotomy to the apical part, and the displacement of the consolidated anterior teeth moved further in case of the consolidated teeth after corticotomy.

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The Relationship of Anxiety, Hopelessness, and Family Suppoort of Breast Cancer Patients Undergoing Chemotherapy (암화학요법을 받는 유방암 환자의 불안, 절망감 및 가족지지와의 관계)

  • Park Jum-Hee;Lee Hyoun-Ju;Kim Hyun-Mi;Lyu Eun-Kyung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.1
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    • pp.147-162
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    • 1997
  • This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al.(1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percentage for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows. In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of state anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a signigicant difference by job and religion, the degree of hopelessness a signigicant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.

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Effects of Exercise Program by Type on Balance Ability and Muscle Activity In A Standing Posture (유형별 운동프로그램이 선 자세에서의 균형능력과 근활성도에 미치는 영향)

  • Kang, Jeong-Il;Park, Jun-Su;Park, Seung-Kyu;Yang, Dae-Jung;Choi, Hyun;Jeong, Dae-Keun;Kwon, Hye-Min;Moon, Young-Jun
    • Journal of Digital Convergence
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    • v.12 no.7
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    • pp.411-418
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    • 2014
  • This study, in order to establish the effect of three exercise groups on the static and dynamic balancing abilities and the muscular activity, targeting adult males aged 20-29, assigned 15 men to each aquatic exercise group, trunk stabilization exercise group, and balance exercise group. The study was conducted from June, 2013 to August, 2013, and measured and compared the balancing ability and the muscle activity(tibialis anterior and gastrocnemius muscle) of the participants after performing intervention for 30 minutes a day, 3 days a week, for 6 weeks. As a result, on the comparison between before and after the intervention, there were significant differences in changes of the surface area and the whole path length in all the three groups(p<.05)(p<.01), and also on the dynamic balance, there was a significant difference in change of limited of stability(p<.05)(p<.01). On change of the muscle activity of tibialis anterior, both left and right sides showed statistically significant differences in all the three groups(p<.05)(p<.01), and gastrocnemius muscle showed a statistically significant difference in all the three groups except for the left side of the trunk stabilization exercise group(p<.05)(p<.01). It could be established that aquatic exercise is effective for improvement of the balancing ability and increase of the muscular activity, and we intend to propose specific aquatic exercise program development by conducting a study to determine the objective effect of aquatic exercise on the elderly or patients who have a poor balancing ability.

Cerebral Activity by Motor Task in Welders Exposed to Manganese through fMRI (fMRI를 이용한 망간 노출 용접공의 운동수행에 따른 뇌 활성도 평가)

  • Choi, Jae-Ho;Jang, Bong-Ki;Lee, Jong-Wha;Hong, Eun-Ju;Lee, Myeong-Ju;Ji, Dong-Ha
    • Journal of Environmental Health Sciences
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    • v.37 no.2
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    • pp.102-112
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    • 2011
  • Objectives: The purpose of this study is to analyze the effects of chronic exposure by welders to manganese (Mn) through an analysis of the degree of brain activity in different activities such as cognition and motor activities using the neuroimaging technique of functional magnetic resonance imaging (fMRI). The neurotoxic effect that Mn has on the brain was examined as well as changes in the neuro-network in motor areas, and the usefulness of fMRI was evaluated as a tool to determine changes in brain function from occupational exposure to Mn. Methods: A survey was carried out from July 2010 to October 2010 targeting by means of a questionnaire 160 workers from the shipbuilding and other manufacturing industries. Among them, 14 welders with more than ten years of job-related exposure to Mn were recruited on a voluntary basis as an exposure group, and 13 workers from other manufacturing industries with corresponding gender and age were recruited as a control group. A questionnaire survey, a blood test, and an fMRI test were carried out with the study group as target. Results: Of 27 fMRI targets, blood Mn concentration of the exposure group was significantly higher than that of the control group (p<0.001), and Pallidal Index (PI) of the welder group was also significantly higher than that of the control group (p<0.001). As a result of the survey, the score of the exposure group in self-awareness of abnormal nerve symptoms and abnormal musculoskeletal symptoms was higher than those of the control group, and there was a significant difference between the two groups (p<0.05, respectively). In the correlation between PI and the results of blood tests, the correlation coefficient with blood Mn concentration was 0.893, revealing a significant amount of correlation (p<0.001). As for brain activity area within the control group, the right and the left areas of the superior frontal cortex showed significant activity, and the right area of superior parietal cortex, the left area of occipital cortex and cerebellum showed significant activity. Unlike the control group, the exposure group showed significant activity selectively on the right area of premotor cortex, at the center of supplementary motor area, and on the left side of superior temporal cortex. In the comparison of brain activity areas between the two groups, the exposure group showed a significantly higher activation state than did the control group in such areas as the right and the left superior parietal cortex, superior temporal cortex, and cerebellum including superior frontal cortex and the right area of premotor cortex. However, in nowhere did the control group show a more activated area than did the exposure group. Conclusions: Chronic exposure to Mn increased brain activity during implementation of hand motor tasks. In an identical task, activation increased in the premotor cortex, superior temporal cortex, and supplementary motor area. It was also discovered that brain activity increase in the frontal area and occipital area was more pronounced in the exposure group than in the control group. This result suggests that chronic exposure to Mn in the work environment affects brain activation neuro-networks.

Association between Antipsychotic-Induced Restless Legs Syndrome and Glutathione S-Transferase Gst-M1, Gst-T1 and Gst-P1 Gene Polymorphisms (Glutathione S-Transferase (GST) 유전자 다형성과 항정신병약물로 유발된 하지불안증후군의 연관 연구)

  • Kang, Seung-Gul;Park, Young-Min;Kim, Leen;Lee, Heon-Jeong
    • Sleep Medicine and Psychophysiology
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    • v.22 no.1
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    • pp.25-29
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    • 2015
  • Objectives: The pathophysiology of restless legs syndrome (RLS) has not been fully elucidated. Oxidative stress might play a role in the development of RLS and other antipsychotic-induced side effects such as tardive dyskinesia. In the present study, we investigated whether the glutathione S-transferase (GST) gene polymorphisms are associated with antipsychotic-induced RLS in schizophrenia. Methods: We assessed antipsychotic-induced RLS symptoms in 190 Korean schizophrenic patients using the diagnostic criteria of the International Restless Legs Syndrome Study Group. The GST-M1, GST-T1 and GST-P1 loci were analyzed using PCR-based methods. Results: We divided the subjects into 2 groups: those with RLS symptoms (n = 96) and those without RLS symptoms (n = 94). There were no significant differences in the distributions of the GST-M1 genotypes (${\chi}^2=3.56$, p = 0.059), GST-T1 (${\chi}^2=0.51$, p = 0.476) and GST-P1 (${\chi}^2=0.57$, p = 0.821) between the 2 groups. Comparison of the RLS score among genotypes of the GST-M1 (t = -1.54, p = 0.125), GST-T1 (t = -0.02, p = 0.985) and GST-P1 (F = 0.58, p = 0.560) revealed no significant difference. Conclusion: These data suggest that GST gene polymorphisms do not confer increased susceptibility to RLS symptoms in schizophrenic patients. Future studies are necessary to evaluate the possible influences of other candidate genes involved in the reactive oxygen species system.

Cyclophosphamide in the Treatment of Idiopathic UIP and NSIP (통상성 간질성 폐렴과 비특이성 간질성 폐렴의 치료에 있어 Cyclophosphamide의 역할)

  • Jeon, Kyeongman;Chung, Man Pyo;Shin, Sung-Chul;Yu, Chang Min;Koh, Won-Jung;Suh, Gee Young;Kim, Hojoong;Kwon, O Jung;Kim, Tae Sung;Lee, Kyung Soo;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.175-187
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    • 2003
  • Background : Although corticosteroid and cytotoxic agent such as cyclophosphamide have been used for the treatment idiopathic interstitial pneumonia (IIP), efficacy of these toxic drugs are unclear because previous reports included the patients who did not undergo surgical lung biopsy and none evaluated the response according to histopathologic entities of IIP. To answer this, we retrospectively analyzed the treatment response and side effects of corticosteroids and cyclophosphamide therapy in patients with idiopathic UIP and NSIP. Methods : Among 61 patients with UIP and 26 patients with NSIP diagnosed by surgical lung biopsy at Samsung Medical Center from July 1996 to June 2002, those who received corticosteroid or cyclophosphamide therapy for at least 6 months and were followed for at least one year after the initiation of treatment were enrolled (32 UIP, 23 NSIP). Treatment response of 55 patients was assessed by ATS response criteria (clinical symptoms, pulmonary function test and radiological findings). Adverse reactions to either agent (42 cases of cyclophosphamide${\pm}$low-dose prednisolone, 49 cases of prednisolone alone) were also analyzed. Results : Irrespective of treatment regimen, NSIP showed more favorable response than UIP (6 months: 78.3% vs. 9.4%, 12 months: 69.6% vs. 9.4%, p<0.001). Cyclophosphamide showed comparable response to corticosteroid in NSIP while its efficacy was as poor as those of corticosteroid therapy in UIP. Significant adverse reaction to drug more frequently occurred in corticosteroid group (35.7%) than cyclophosphamide group (14.3%) (p=0.017). Conclusion : Cyclophosphamide is effective and more tolerable than corticosteroids in the treatment of idiopathic nonspecific interstitial pneumonia.

Effects of Sourdough on the Quality Characteristics of Rye-Wheat Mixed Bread (Sourdough 대체가 호밀-밀 혼합빵의 품질 특성에 미치는 영향)

  • Kim, Mun-Yong;Chun, Soon-Sil
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.5
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    • pp.625-632
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    • 2008
  • Rye-wheat mixed bread samples made with substitutions of 20, 40, 60 and 80% sourdough, and control made with the addition of naturally fermented raisin extract, were examined for quality characteristics such as pH, total titratable acidity, fermentation power of dough expansion, specific volume, baking loss, water activity, color, texture, external and internal surface appearance, and sensory qualities, in order to determine the optimal ratio of sourdough in the formulation. As the incubation time of sourdough increased, pH decreased, while total titratable acidity increased. The pH of rye-wheat mixed doughs decreased with increasing sourdough content, but total titratable acidity increased. The rye-wheat mixed breads prepared with substitutions of sourdough had higher pH and lower total titratable acidity than the control group. Fermentation power of dough expansion of rye-wheat mixed doughs increased with increasing incubation time. Specific volume was maximum on the 20% substitution sourdough. Baking loss was inferior with the 80% substitution sourdough. Water activity and lightness was minimum on the control group. The higher amounts of sourdough showed the higher tendency of lightness, redness and yellowness. In the texture characteristics, hardness, gumminess, and chewiness was minimum on the control group and tended to increase with higher substitution of sourdough. Substitution of sourdough showed decrease adhesiveness. Fracturability, cohesiveness, and resilience of all rye-wheat mixed breads were not significantly different. Springiness was maximum on the 20% substitution sourdough and minimum on the 40%. A side of loaf of rye-wheat mixed breads, except for 20%, had a poor break and shred. In sensory evaluation, as substitution amount of sourdough increased, the scores of color and consistency of crumb, uniformity of crumb pore, gumminess, and overall acceptability decreased; while the density of crumb pore, springiness of crumb, aroma of rye flour, sourness, and bitterness showed the reverse effect; the 20, 40, and 60% sourdough samples obtained fairly good scores. In conclusion, these results indicated that $20{\sim}60%$ of sourdough could be very useful as a substitute for baker's yeast in developing rye-wheat mixed bread.

Effects of Some Environmental Factors on Japanese Yew (Taxus cuspidata Sieb. et Zucc.) (몇 발근환경인자(發根環境因子)가 주목삽수(揷穗) 발근(發根)에 미치는 효과(効果))

  • Kim, Chang Ho;Nam, Jung Chil
    • Journal of Korean Society of Forest Science
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    • v.70 no.1
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    • pp.1-6
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    • 1985
  • The purpose of this experiment lies in finding the most appropriate cutting condition of Taxus cuspidata Sieb. et Zucc. which has been considered valuable tree species in gardening. Statistical analysis was focused on the comparison of the average ratios of rooting between greenhouses and fields, based on the observation rooted autogenis. To conduct this survey, hardwood cutting of Taxus cuspidata Sieb. et Zucc. were performed at both places of experiment above on April 20, 1982 with rooting results calculated on October 31, 1982. After formation of cuttings, it was soaked in IBA 200 ppm for 12 hours and than put in a bed. A summary of the result is presented as follows; 1) Cutting at the greenhouse showed higher average rate of rooting than at fields. Same tendency was found regardless of the differences in treatment. 2) It was clear that IBA-treatment contributed remarkably to causing higher average rooting rate. As an evidence, when twenty centimeter cuttings were inserted sandy media, IBA-treated area resulted in eighty six percent of average rooting rate, as compared with only twenty three percent in nontreatment case. In case of field cutting, IBA-treatment brought about fifty three percent of rooting in comparison with eleven percent nontreatment. 3) When sandy soil, loam and brown soil were separately used as cutting media, the highest rooting rate was found in case of sandy soil, without any difference between the two experimental places above. 4) As a result of the analysis to seek the impact of the length of cuttings on rooting, the range of length form fifteen to twenty centimeter was apparently most appropriate. It was also found that the rate of rooting declined beyond twenty five centimeter. 5) Two kinds of rooting pattern were observed. One was the case that callus cell lump was created on the lower cut side of cuttings. Importantly, root radical were formed inside the lump to influence the germination of root system. The other relates to the case that adventitious root which look like lateral roots appeared at the stem region. In abstract, first, sandy soil was effectively recommended in case of hardwood cutting in April. Second, the most appropriate length of cuttings ranged between fifteen and twenty centimeters. Third, high density IBA treatment was clearly effective. Forth, for proper environmental management, both pre-disinfection of sail by sterilizer and maintenance of high relative humidity were essentially required.

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