• Title/Summary/Keyword: clinical guidance

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Ultrasound-guided Core Needle Biopsy in Diagnosis of Soft Tissue Masses (연부조직 종물의 진단에서 초음파 유도하 중심부 침생검)

  • Kim, Jeung-Il;Youn, Myung-Soo;Cheon, Sang-Jin;Choi, Gyung-Un;Lee, Tae-Hong
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.113-119
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    • 2004
  • Purpose: To determine the utility of sonographically guided percutaneous core needle biopsy to diagnose musculoskeletal soft tissue masses. Methods: A prospective study was performed in 55 patients referred for image-guided needle biopsy of primary or recurrent soft tissue masses and bone lesion or suspected solitary metastasis with extraosseous masses. Tissue samples were obtained with a 14-gauge or 18-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 49 biopsies confirmed by successful clinical treatment (11 cases) or surgical resection (38 cases). Results: An accurate diagnosis was obtained in 47 (97%) of 49 biopsies; sensitivity was 95%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 6 cases. Considering all 55 biopsies, high-quality specimens were obtained in 87%. There were no serious complications. Conclusions: Sonographically guided core needle biopsy is accurate and safe, in soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.

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Patent Ductus Arteriosus Occlusion with an $Amplatz^{(R)}$ Canine Duct Occluder in a Dog (개에서 $Amplatz^{(R)}$ Canine Duct Occluder를 이용한 동맥관개존증의 폐쇄 증례)

  • Kang, Min-Hee;Kim, Seung-Gon;Hahn, Tae-Yeon;Park, Hyun-Ah;Min, Sa-Hee;Park, Ji-Hwan;Kim, Tae-Woo;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.498-501
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    • 2012
  • A 10-month-old intact male Maltese dog (body weight, 1.6 kg) presented with intermittent cough and abnormal heart sounds. The dog was diagnosed with a left-to-right patent ductus arteriosus (PDA) on the basis of the results of transthoracic echocardiography, color flow Doppler examination, and angiography. Transcatheter occlusion of the PDA was performed using the $Amplatz^{(R)}$ Canine Duct Occluder (ACDO) via the femoral artery. The device was placed under fluoroscopic guidance and successfully occluded the PDA. The continuous heart murmur disappeared immediately after the correction and no residual flow was detected. The dog was discharged the following day and regularly examined for complications and safety. This is the first report demonstrating the clinical application of ACDO for the transcatheter closure of PDA via the femoral artery in a small-breed dog in Korea.

Development of healthy Han-sik nutrition education program featuring consumption of Korean foods for prevention of metabolic syndrome in Korean adults (한국 성인의 대사증후군 예방을 위한 건강한식 교육프로그램 개발)

  • Kang, Minji;Paik, Hee Young;Wie, Gyung-Ah;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.45 no.6
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    • pp.552-561
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    • 2012
  • Metabolic syndrome is a cluster of metabolic risk factors associated with increased risk of cardiovascular diseases. Recently, the prevalence of metabolic syndrome has increased in Korea. The aim of this study was to develop a Healthy Han-sik Nutrition Education Program (HHNEP) based on commonly recognized Korean foods in order to decrease metabolic syndrome risks. The target population of the HHNEP is adults with metabolic risk factors. The initial version of the HHNEP was developed based on a review of literature and various dietary guidelines by expert committees as well as the results of a survey on the perception of common Korean dishes and foods as Han-sik. The focus group discussion conducted of nine participants from the target population. After minor modification, the final version was developed. The contents included five sections: 1) aims, 2) introduction of Korean Food Guidance System, 3) cholesterol contents in food, 4) menu planning method using Han-sik, and 5) examples of daily Han-sik menu. The Han-sik list was selected based on the results from a Han-sik perception answered by 35 Korean adults aged 30-60 years using 517 frequently consumed Korean foods from the fourth Korea National Health and Nutrition Examination Survey. The nutrition education program was developed based on scientific evidence for the prevention of metabolic syndrome and focuses on tailoring education to an individual's dietary problems. Educational method was developed by a group of expert committees based in planned behavior theory and related research results. The education method consisted of assessment of current diet, four face-to-face nutrition education sessions over 8 weeks, and evaluation after 8 and 16 weeks. Initial version of nutrition education materials and methods was tested for feasibility by a select group of nine Korean healthy adults. Successful implementation of the program would include application by nutritional professionals at the health promotion center of the hospitals, public health center, and work sites. Intervention studies are needed to evaluate the feasibility and effectiveness of this program before large-scale applications.

Clinical Significance of Detecting Lymphatic and Blood Vessel Invasion in Stage II Colon Cancer Using Markers D2-40 and CD34 in Combination

  • Lai, Jin-Huo;Zhou, Yong-Jian;Bin, Du;Qiangchen, Qiangchen;Wang, Shao-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1363-1367
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    • 2014
  • This research was conducted to compare differences in colon cancer lymphatic vessel invasion (LVI) with D2-40 antibody labeling and regular HE staining, blood vessel invasion (BVI) with CD34 antibody labeling and HE staining and to assess the possibility of using D2-40-LVI/CD34-BVI in combination for predicting stage II colon cancer prognosis and guiding adjuvant chemotherapy.Anti-D2-40 and anti-CD34 antibodies were applied to tissue samples of 220 cases of stage II colon cancer to label lymphatic vessels and small blood vessels, respectively. LVI and BVI were assessed and multivariate COX regression analysis was performed for associations with colon cancer prognosis. Regular HE staining proved unable to differentiate lymphatic vessels from blood vessels, while D2-40 selectively labeled lymphatic endothelial cell cytosol and CD34 was widely expressed in large and small blood vessels of tumors as well as normal tissues. Compared to regular HE staining, D2-40-labeling for LVI and CD34-labeling for BVI significantly increased positive rate (22.3% vs 10.0% for LVI, and 19.1% vs 9.1% for BVI). Multivariate analysis indicated that TNM stage, pathology tissue type, post-surgery adjuvant chemotherapy, D2-40-LVI, and CD34-BVI were independent factors affecting whole group colon cancer prognosis, while HE staining-BVI, HE staining-LVI were not significantly related. When CD34-BVI/D2-40-LVI were used in combination for detection, the risk of death for patients with two or one positive results was 5.003 times that in the LVI(-)&BVI(-) group (95% CI 2.365 - 9.679). D2-40 antibody LVI labeling and CD34 antibody BVI labeling have higher specificity and accuracy than regular HE staining and can be used as molecular biological indicators for prognosis prediction and guidance of adjuvant chemotherapy for stage II colon cancer.

Elucidating Bottlenecks to the Efficient Preparation of AB5-Hexamer Mucosal Adjuvant Protein LTm by Genetic Engineering

  • Liu, Di;Hu, Fabiao;Wang, Wenpeng;Wu, Dong;He, Xiujuan;Zheng, Wenyun;Liu, Haipeng;Ma, Xingyuan
    • Journal of Microbiology and Biotechnology
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    • v.27 no.8
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    • pp.1461-1471
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    • 2017
  • Escherichia coli heat-labile enterotoxin (LT) and its non-toxic mutant (LTm) are well-known powerful mucosal adjuvants and immunogens. However, the yields of these adjuvants from genetically engineered strains remain at extremely low levels, thereby hindering their extensive application in fundamental and clinical research. Therefore, efficient production of these adjuvant proteins from genetically engineered microbes is a huge challenge in the field of molecular biology. In order to explore the expression bottlenecks of LTm in E. coli, we constructed a series of recombinant plasmids based on various considerations and gene expression strategies. After comparing the protein expression among strains containing different recombinant plasmids, the signal sequence was found to be critical for the expression of LTm and its subunits. When the signal sequence was present, the strong hydrophobicity and instability of this amino acid sequence greatly restricted the generation of subunits. However, when the signal sequence was removed, abundantly expressed subunits formed inactive inclusion bodies that could not be assembled into the hexameric native form, although the inclusion body subunits could be refolded and the biological activity recovered in vitro. Therefore, the dilemma choice of signal sequence formed bottlenecks in the expression of LTm. These results reveal the expression bottlenecks of LTm, provide guidance for the preparation of LTm and its subunits, and certainly help to promote efficient preparation of this mucosal adjuvant protein.

The Efficacy of Fluorograb for Paediatric Patients Dose Reduction during Pneumatic Reduction and Voiding Cystourethrography (VCUG) (영아/유아의 공기 주입 정복술 및 방사선 배뇨성 방광요도 조영술시 피폭 선량 경감을 위한 FluroGrab의 유용성)

  • Kim, Sang-Tae;Choi, Ji Won;Han, Tae-Jong
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.1167-1172
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    • 2009
  • The Pneumatic Reduction and VCUG (Voiding Cystourethrography) are commonly used in the paediatric age group. The procedures had a particularly long fluroscopic screening time, despite a successful outcome for paediatric patients. Pneumatic Reduction and VCUG almost invariably requires fluoroscopic guidance which does confer a radiation dose. This article contains suggestions on how the radiation dose to paediatric patients from Pneumatic Reduction and VCUG can be made "as low as reasonably achievable" (ALARA). The aim of our study was eliminated in spot image applying the FluoroGrab, which has function of capturing an image of interest area from the picturing while fluoroscopic procedures. FluoroGrab has clinical value equivalent to the spot image, and is applied to the most recent fluoroscopic procedures. The radiologist and the radiographers should consider new option for decreasing the radiation exposure delivered to paediatric patients by making equipment modifications to the fluoroscopy to optimize radiation exposure reduction techniques. Thus, we propose the FluoroGrab instead of spot exposure for the reduction of patient exposure dose in paediatric, and try to confirm the effect of the mitigating amount of radiation exposure to paediatric patients when pneumatic reduction and VCUG. Fluorograb is the safe and useful method that shows the equivalent level of accuracy to spot exposure, and to minimize the radiation load to paediatric patients are to be the substitute for the spot exposure for Pneumatic Reduction and VCUG.

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Whole pelvic intensity-modulated radiotherapy for high-risk prostate cancer: a preliminary report

  • Joo, Ji Hyeon;Kim, Yeon Joo;Kim, Young Seok;Choi, Eun Kyung;Kim, Jong Hoon;Lee, Sang-Wook;Song, Si Yeol;Yoon, Sang Min;Kim, Su Ssan;Park, Jin-Hong;Jeong, Yuri;Ahn, Hanjong;Kim, Choung-Soo;Lee, Jae-Lyun;Ahn, Seung Do
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.199-205
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    • 2013
  • Purpose: To assess the clinical efficacy and toxicity of whole pelvic intensity-modulated radiotherapy (WP-IMRT) for high-risk prostate cancer. Materials and Methods: Patients with high-risk prostate cancer treated between 2008 and 2013 were reviewed. The study included patients who had undergone WP-IMRT with image guidance using electronic portal imaging devices and/or cone-beam computed tomography. The endorectal balloon was used in 93% of patients. Patients received either 46 Gy to the whole pelvis plus a boost of up to 76 Gy to the prostate in 2 Gy daily fractions, or 44 Gy to the whole pelvis plus a boost of up to 72.6 Gy to the prostate in 2.2 Gy fractions. Results: The study cohort included 70 patients, of whom 55 (78%) had a Gleason score of 8 to 10 and 50 (71%) had a prostate-specific antigen level > 20 ng/mL. The androgen deprivation therapy was combined in 62 patients. The biochemical failure-free survival rate was 86.7% at 2 years. Acute any grade gastrointestinal (GI) and genitourinary (GU) toxicity rates were 47% and 73%, respectively. The actuarial rate of late grade 2 or worse toxicity at 2 years was 12.9% for GI, and 5.7% for GU with no late grade 4 toxicity. Conclusion: WP-IMRT was well tolerated with no severe acute or late toxicities, resulting in at least similar biochemical control to that of the historic control group with a small field. The long-term efficacy and toxicity will be assessed in the future, and a prospective randomized trial is needed to verify these findings.

Evaluation of the National Train-the-Trainer Program for Hospice and Palliative Care in Korea

  • Kang, Jina;Yang, Eunbae B.;Chang, Yoon Jung;Choi, Jin Young;Jho, Hyun Jung;Koh, Su Jin;Kim, Won Chul;Choi, Eun-Sook;Kim, Yeol;Park, Sung-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.501-506
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    • 2015
  • Background: To evaluate the effectiveness of the National Train-the-Trainers Program for Hospice and Palliative Care Experts (TTHPC) sponsored by the National Cancer Center of Korea between 2009 and 2012. This program was developed to improve the teaching skills of those in the field of hospice and palliative care (HPC). Materials and Methods: Training was offered in eight 1-day sessions between 2009 and 2012. The effect of the program was measured using Kirkpatrick's model of educational outcomes. First, levels 1 and 2 were evaluated immediately after the 1-day program (n=120). In 2012, the level-3 evaluation test was administered to trainers who offered at least one HPC training (n=78) as well as to their trainees (n=537). Results: The level-1 evaluation addressed participant reactions to and satisfaction with the program. Participants (n=120) were generally satisfied with the content, the method, and the overall course (mean range: 3.94-4.46 on a five-point Likert scale). The level-2 evaluation (learning) showed that participants gained knowledge and confidence related to teaching HPC (4.24 vs. 4.00). The level-3 evaluation (behavioral), which assessed trainers' application of teaching skills to HPC, showed that trainees rated the teaching methods of trainers (mean range: 4.03-4.08) more positively than did trainers (p<0.05). Female trainers were more likely than were male trainers to plan sessions in consideration of their trainees' characteristics (4.11 vs. 3.58; p<0.05), and nurse trainers were more likely than physician trainers to use a variety of instructional methods (4.05 vs. 3.36; p<0.05) Conclusions: We conducted systematic evaluations based on Kirkpatrick's model to assess the effectiveness of our train-the-trainers program. Our educational program was practical, effective, and followed by our HPC experts, who needed guidance to learn and improve their clinical teaching skills.

Evaluation of 358 Mandibular Poster ior Implants: A 3-year Retrospective Study (하악 구치부위에 식립한 358개 임플란트의 생존율에 대한 3년간 후향적 연구)

  • Yoon, I-Kwon;Lee, Gi;Lee, Dong-Un;Choi, Ju-Young;Yu, Jeong-A;Park, Pil-Gyu;Kim, Jeong-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.1
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    • pp.59-68
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    • 2010
  • Recently, dental implants extensively inserted on edentulous area show highly clinical success rate. However, clinicians cannot exclude the possibility of failure and it often unexpectively occures. Many possible factors associated with failure of dental implants have been reported but controversy exists over the extent to them. In this study, we collected 212 patients who had been inserted 358 dental implants on mandibular premolar and molar area from 2005 to 2006. The survival rate of fixtures was recorded according to age of patients, implantation site, implant system, diameter and length of fixtures. Multi-variable analysis using SPSS chi-square test was operated to verify relation of each factors and survival rates. Accumulative survival rate was 98.3% for 3 years. Only diameter of fixtures was related to the implant survival rate. This may be thought that wider fixtures had been chosen to rescue implants or used in sites of poor bone quality. Further continuous study will be needed for direct guidance associated with survival rate of implants.

A Study of Current Employment and Future Trends for Young Home Economists (가정학 전공자의 취업과 전망)

  • 문수재
    • Journal of the Korean Home Economics Association
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    • v.20 no.3
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    • pp.85-102
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    • 1982
  • The current employment status among young home economists and perspectives in occupations for prospective Home Economics graduates were explored in this study which utilized information from 17 to 21 colleges in Korea and colleges in the United States during the five years of 1977∼1981. The Home Economics content areas covered in this study were Clothing and Textiles, Foods and Nutrition, Housing and Interior Design, and Child Development and Family Life. The highest percentage of Korean graduates in Clothing and Textiles was employed either as teachers at the junior high school level or as designers in the clothing and textile industries. Quite a number of the graduates were engaged in further studies at the graduate level. Korean graduates with a master's degree were teaching at the college level and some had furthered their studies at the doctorate level either here or abroad. Koreans with a bachelor's degree in Foods and Nutrition held jobs as teachers in junior high school, dieticians at mass feeding institutions and hospitals, food scientists in food industries, and researchers in institutions. Those with a master's degree were teaching at the college level. Americans with a bachelor's degree worked as dieticians, supervisors in restaurants and institutions, extension workers, researchers at various facilities, teachers and clerks. Americans with a master's or doctorate degree were engaged in teaching at colleges or supervising at research or working as extension specialists. In general, Korean graduates were found to hold positions in less varied areas than their American counter-parts. Among forty-nine graduates those working in their professional field reported less sex discrimination that those working in other fields. The major area of employment in Housing and Interior Design or Home Management graduates in Korea was teaching while in the United States it was extension work, business, governmental work and teaching. It was suggested that in the future, career development in Korea be further explored to include extension service, research, social welfare, financial planning, business, free-lancing, funeral home, home-call, and correctional education. Interviews with executives from 6 business enterprises indicated that most of them were aware of the potential contribution home economists could make for their companies but they expressed a negative attitude towards women in general due to their short stay on the job. Jobs held by Child Development and Family Life majors with a bachelor's degree in Korea were mostly teaching positions in public, junior and senior high school. However, jobs such as nursery school teaching, working in clinical setting, business, and teaching at public, junior and senior high school predominated in the United states. Most Korean graduates with a master's degree were teaching in professional colleges while in the United Stated the job variation among the graduates was rather evenly distributed among teaching at college level, public and high school, nursery school and administration areas. Reports from 7 child development majors on the job indicated that they were paid less that secretarial workers. Only half of them were working in their major area and these expressed satisfaction with their work. Two thirds of the respondents indicated no sex discrimination. It was suggested that in the future Child Development and Family Life majors pursue employment in counseling, guidance, recreation, mass media, administration and outreach work as well as education, research and parent education in services for children, teen-agers, adults and families.

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