• Title/Summary/Keyword: Standard methods

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Patient's Selection for Extracorporeal Shock Wave Lithotripsy for Treatment of Common Bile Duct Stones Resistant to Endoscopic Extraction (체외충격파쇄석술 적용을 위한 총담관결석의 선택)

  • Lee, Won-Hong;Son, Soon-Yong;Kim, Chang-Bok;Park, Cheon-Kyoo;Kang, Seong-Ho;Ryu, Meung-Sun;Lee, Yong-Moon
    • Journal of radiological science and technology
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    • v.28 no.2
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    • pp.105-110
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    • 2005
  • Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

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A COG Variable Analysis of Air-rolling-breakfall in Judo (유도 공중회전낙법의 COG변인 분석)

  • Kim, Eui-Hwan;Chung, Chae-Wook;Kim, Sung-Sup
    • Korean Journal of Applied Biomechanics
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    • v.15 no.3
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    • pp.117-132
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    • 2005
  • It was to study a following research of "A Kinematic Analysis of Air-rolling-breakfall in Judo". The purpose of this study was to analyze the Center of Gravity(COG) variables when performing Air-rolling-breakfall motion, while passing forward over(PFO) to the vertical-hurdles(2m height, take off board 1m height) in judo. Subjects were four males of Y. University squad, who were trainees of the demonstration exhibition team, representatives of national level judoists and were filmed by four 5-VHS 16mm video cameras(60field/sec.) through the three dimensional film analysis methods.COG variable were anterior-posterior directional COG and linear velocity of COG, vertical directional COG and linear velocity of COG. The data collections of this study were digitized by KWON3D program computed The data were standardized using cubic spline interpolation based by calculating the mean values and the standard deviation calculated for each variables. When performing the Air-rolling-breakfall, from the data analysis and discussions, the conclusions were as follows : 1. Anterior-posterior directional COG(APD-COG) when performing Air-rolling-breakfall motion, while PFO over to the vertical-hurdles(2m height) in judo. The range of APD-COG by forward was $0.31{\sim}0.41m$ in take-off position(event 1), $1.20{\sim}1.33m$ in the air-top position(event 2), $2.12{\sim}2.30m$ in the touch-down position(event 3), gradually and $2.14{\sim}2.32m$ in safety breakfall position(event 4), respectively. 2 The linear velocity of APD-COG was $1.03{\sim}2.14m/sec$. in take-off position(event 1), $1.97{\sim}2.22m/sec$. gradually in the air-top position(event 2), $1.05{\sim}1.32m/sec$. in the touch-down position (event 3), gradual decrease and $0.91{\sim}1.23m/sec$. in the safety breakfall position(event 4), respectively. 3. The vertical directional COG(VD-COG) when performing Air-rolling-breakfall motion, while PFO to the vertical-hurdles(2m height) in judo. The range of VD-COG toward upward from mat was $1.35{\sim}1.46m$ in take-off position(event 1), the highest $2.07{\sim}2.23m$ in the air-top position(event 2), and after rapid decrease $0.3{\sim}0.58m$ in the touch-down position(event 3), gradual decrease $0.22{\sim}0.50m$ in safety breakfall position(event 4), respectively. 4. The linear velocity of VlJ.COG was $1.60{\sim}1.87m/sec$. in take-off position(event 1), $0.03{\sim}0.08m/sec$. gradually in the air-top position(event 2), $-4.37{\sim}\;-4.76m/sec$. gradual decrease in the touch-down position(event 3), gradual decrease and -4.40${\sim}\;-4.77m/sec$. in safety breakfall position(event 4), respectively. When performing Air-rolling-breakfall showed parabolic movement from take-off position to air-top position, and after showed vertical fall movement from air-top position to safety breakfall. In conclusion, Ukemi(breakfall) is safety fall method Therefore, actions need for performing safety fall movement, that decrease and minimize shock and impact during Air-rolling-breakfall from take-off board action to air-top position must be maximize of angular momentum, and after must be minimize in touch-down position and safety breakfall position.

Clinical Research for Otitis Media with Effusion Using Tympanometry (Tympanometry를 이용한 삼출성 중이염의 임상적 관찰에 대한 연구)

  • Park, Owe-Suk;Yoon, Hui-Sung;Kim, Hee-Jeong;Kim, Keoo-Seok;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.18 no.3
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    • pp.84-94
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    • 2005
  • Objective: In order to help clinical approach on OME patient in progress observation and decision on improvement by clinical research results using tympanometry. Methods: Data was collected from 163 ears of 96 patients who were treated in Dept. of Oriental Medical Ophthalmology & Otolaryngology & Dermatology, Kyung-Hee Medical Center from 2001-2-12 to 2005-4-29 for Otitis Media with Effusion(OME). Tympanometry was applied to all patients and the test result was used to evaluate progress and improvement. F/U cases below 3 times were excluded. Results & conclusion: 1. Age and sex distribution was as follows: Mean Age 5.5years old(Standard deviation: 2.1), age distribution 2-61years old, below 10years old 151cases(92.6%) and above 10years old 12cases(7.4%). Male and female ratio was 1.81:1. 2. There were 67people(69.8%) with bilateral affected ear. Unilateral was 29people(30.2%). Affected ear distribution according to sex came out similarly. 3. Affected period distribution was as follows: over 12weeks 71cases(43.6%), under 12weeks 92cases(56.4%). Out of under 12weeks cases, 2-4weeks was 34cases(20.9%), 0-1weeks and 5-8weeks 20cases(12.3%), 9-12weeks 18cases(11.0%). There was evident difference about affected period between male and female. 4. All patients who served previous Tx in medical clinic(118 cases) took antibiotics. Only 6cases took tube insertion. The period of Taking antibiotics was as fellows: over 6weeks 42cases(35.6%), under 5weeks 37cases(31.4%). unknown 25cases(21.2%), jntermittent 14cases(11.9%). 5. In Period of Tx distribution, 5-6weeks showed 40cases(24.5%) which was highest number. In Improved cases(85cases), 3-4weeks and 5-6weeks each 22cases(25.9%) which was highest number. 1-2weeks 3cases(3.5%), 7-8weeks 12cases(14.1%), 9-10weeks 9cases(10.6%), 11-12weeks 10cases(11.8%), over 12weeks 7cases(8.2%). 6. The cases which have gastrointestinal Sx were 71cases(43.6%), the others 92cases(56.4%). Details of gastrointestinal Sx were as follows: Sx associated with appetite 47cases(47.5%), constipation 15cases(15.2%), abdominal pain and diarrhea 14cases(14.1%), frequent vomitting Teases(7.1%), etc 4cases(4.0%). 7. The cases which have accompanying disease were 116case(71.2%), the other 47cases(28.8%). Details a accompanying disease were as follows: sinusitis 57cases(35%), rhinitis 55cases(3.7%), allergic rhinitis 20cases(12.3%), atopic dermatitis 19cases(1.7%), urticaria 4cases(2.5%), asthma 3cases(1.8%), nasal polyp and conjunctivitis 2cases(1.2%) each, laryngitis 1case(0.6%).

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Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer (국소 진행된 두경부암 환자의 방사선치료 후 갑상샘기능저하증)

  • Lee, Jeong-Eun;Kim, Jae-Chul;Yea, Ji-Woon;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.64-70
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    • 2010
  • Purpose: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. Materials and Methods: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. Results: The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Conclusion: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.

Magnetic Properties of Electroless Co-Mn-P Alloy Deposits (무전해 Co-Mn-P 합금 도금층의 자기적 특성)

  • Yun, Seong-Ryeol;Han, Seung-Hui;Kim, Chang-Uk
    • Korean Journal of Materials Research
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    • v.9 no.3
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    • pp.274-281
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    • 1999
  • Usually sputtering and electroless plating methods were used for manufacturing metal-alloy thin film magnetic memory devices. Since electroless plating method has many merits in mass production and product variety com­pared to sputtering method, many researches about electroless plating have been performed in the United State of America and Japan. However, electroless plating method has not been studied frequently in Korea. In these respects the purpose of this research is manufacturing Co-Mn-P alloy thin film on the corning glass 2948 by electroless plating method using sodium hypophosphite as a reductant, and analyzing deposition rate, alloy composition, microstructure, and magnetic characteristics at various pH's and temperatures. For Co-P alloy thin film, the reductive deposition reaction 0$\alpha$urred only in basic condition, not in acidic condition. The deposition rate increased as the pH and temperature increased, and the optimum condition was found at the pH of 10 and the temperature of $80^{\circ}C$. Also magnetic charac­teristics was found to be most excellent at the pH of 9 and the temperature of $70^{\circ}C$, resulting in the coercive force of 8700e and the squareness of 0.78. At this condition, the contents of P was 2.54% and the thickness of the film was $0.216\mu\textrm{m}$. For crystal orientation, we could not observe fcc for $\beta$-Co. On the other hand,(1010), (0002), (1011) orientation of hcp for a-Co was observed. We could confirm the formation of longitudinal magnetization from dominant (1010) and (1011) orientation of Co-P alloy. For Co-Mn-P alloy deposition, coercive force was about 1000e more than that of Co P alloy, but squareness had no difference. For crystal orientation, (l01O) and (lOll) orientation of $\alpha$-Co was dominant as same as that of Co- P alloy. Likewise we could confirm the formation of longitudinal magnetization.

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Susceptibility tests of oral antibiotics including cefixime against Escherichia coli, isolated from pediatric patients with community acquired urinary tract infections (소아 원외 요로감염 환아에서 분리된 E. coli에 대한 cefixime을 포함한 경구 항생제의 감수성 연구)

  • Lee, Soo Young;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kim, Sun Mi;Ma, Sang Hyuk;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.777-783
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    • 2006
  • Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

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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Clinical Application of Wedge Factor (Wedge Factor의 임상적 응용)

  • Choi Dong-Rak;Ahn Yong-Chan;Huh Seung Jae
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.291-296
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    • 1995
  • Purpose : In general, the wedge factors which are used clinical practices are ignored of dependency on field sizes and depths. In this present, we investigated systematically the depth and field size dependency to determine the absorbed dose more accurately. Methods : The wedge factors for each wedge filter were measured at various depths (depth of Dmax, 5cm, 10cm, and 15cm) and field sizes ($5cm{\times}5cm,\;10cm{\times}10cm,\;15cm{\times}15cm, and 20cm{\times}20cm$) by using 4-, 6-, and 10-MVX rays. By convention, wedge factors are determined by taking the ratio of the central axis ionization readings when the wedge filter is in place to those of the open field in same field size and measurement depth. In this present work, we determined the wedge factors for 4-, 6-, and 10-MV X rays from Clinac 600C and 2100C linear accelerators (manufactured by Varian Associates, Inc., Palo Alto, CA). To confirm that the wedge was centered, measurements were done with the two possible wedge position and various collimator orientations. Results : The standard deviations of measured values are within $0.3\;\%$ and the depth dependence of wedge factor is greater for the lower energies. Especially, the variation of wedge factor is no less than $5\%$ for 4- and 6- MV X rays with more than $45^{\circ}$ wedge filters. But there seems to be a small dependence on field size. Conclusion : The results of this study show a dependence on the point of measurement. There also seems to be a small dependence on field size. And so, we should consider the depth and field size dependence in determining the wedge factors. If one wedge factor were to be used for each wedge filter it seems that the measurement for a 10cm x 10cm field size at a depth of loom would be a reasonable choice.

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A Seroepidemiologic Study of Hepatitis A Virus in the Healthy Children and Adolescent in Kyonggi-do Province (경기도 지역의 건강한 소아와 청소년에서 A형 간염 바이러스의 항체 보유율에 대한 역학 조사)

  • Roh, Hye Ok;Sohn, Young Mo;Park, Min Soo;Choi, Boyoul;Bang, Keum Nie;Ki, Moran;Kim, Ji Hee
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.232-239
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    • 1997
  • Purpose: The incidence of hepatitis A virus(HAV) infection has markedly decreased in the last 20 years due to industrialization and improvements in the standard of living and hygiene in Korea. The reduction in seroprevalence rates indicates infection potential for young adult population, and a need for vaccinations in high-risk adults and children groups has been suggested. In this study we evaluated the seroprevalence rates and natural infection rates of hepatitis A in children and adolescent to obtain the basic data for vaccination of hepatitis A. Methods: A total of 334 children and adolescent subjects below 20 years old in Kyonggi-do province were examined for HAV antibody and seroprevalence rates in each age group was investigated. In 584 elementary school students residing in Kyonggi-do province, serum samples collected in 1993 and 1996 from the same subjects for investigation of natural seroconversion rates. Method of testing antibody was enzyme immunoassay. Results: 1) The seropositive rate of HAV in 334 subjects aged below 20 years old was 5.4%. According to age, the seropositive rates were 27.3% in infant group, 0.0% in 1~4 year-old group, 0.0% in 5~9 year-old group, 2.9% in 10~14 year-old group and 15.0% in 15~19 year-old group. 2) In the study of 584 elementary school children, only one subject showed seropositive in 1993, and in 1996 three different subjects showed seropositive results(0.5%); the natural seroconversion rate during 3 years was 0.5%. 3) The seroprevalence rates of below 20 year-old subjects reported in previous studies were 63.8% in 1979 and 47.3% in 1989 while the present study showed the rate at 5.4%. Conclusion: Since natural antibody formation is rarely occurring, there is a high risk for apparent hepatitis A infection in adults. Therefore vaccination in high risk groups is essential at present, and in order to reduce the chance for hepatitis A infection in adults, vaccination in children may be needed.

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Determination of plasma C16-C24 globotriaosylceramide (Gb3) isoforms by tandem mass spectrometry for diagnosis of Fabry disease (패브리병(Fabry) 진단을 위한 혈장 중 Globotriaosylceramide (Gb3)의 탠덤매스 분석법 개발과 임상 응용)

  • Yoon, Hye-Ran;Cho, Kyung-Hee;Yoo, Han-Wook;Choi, Jin-Ho;Lee, Dong-Hwan;Zhang, Kate;Keutzer, Joan
    • Journal of Genetic Medicine
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    • v.4 no.1
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    • pp.45-52
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    • 2007
  • Purpose : A simple, rapid, and highly sensitive analytical method for Gb3 in plasma was developed without labor-ex tensive pre-treatment by electrospray ionization MS/ MS (ESI-MS/MS). Measurement of globotriaosy lceramide (Gb3, ceramide trihex oside) in plasma has clinical importance for monitoring after enzyme replacement therapy in Fabry disease patients. The disease is an X-linked lipid storage disorder that results from a deficiency of the enzyme ${\alpha}$-galactosidase A (${\alpha}$-Gal A). The lack of ${\alpha}$-Gal A causes an intracellular accumulation of glycosphingolipids, mainly Gb3. Methods : Only simple 50-fold dilution of plasma is necessary for the extraction and isolation of Gb3 in plasma. Gb3 in diluted plasma was dissolved in dioxane containing C17:0 Gb3 as an internal standard. After centrifugation it was directly injected and analyzed through guard column by in combination with multiple reaction monitoring mode of ESI-MS/MS. Results : Eight isoforms of Gb3 were completely resolved from plasma matrix. C16:0 Gb3 occupied 50% of total Gb3 as a major component in plasma. Linear relationship for Gb3 isoforms w as found in the range of 0.001-1.0 ${\mu}g$/mL. The limit of detection (S/N=3) was 0.001 ${\mu}g$/mL and limit of quantification was 0.01 ${\mu}g$/mL for C16:0 Gb3 with acceptable precision and accuracy. Correlation coefficient of calibration curves for 8 Gb3 isoforms ranged from 0.9678 to 0.9982. Conclusion : This quantitative method developed could be useful for rapid and sensitive 1st line Fabry disease screening, monitoring and/or diagnostic tool for Fabry disease.

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