• Title/Summary/Keyword: clinical index

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Study on Tumor Control Probability and Normal Tissue Complication Probability in 3D Conformal Radiotherapy (방사선 입체조형치료에 대한 종양치유확율과 정상조직손상확율에 관한 연구)

  • 추성실
    • Progress in Medical Physics
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    • v.9 no.4
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    • pp.227-245
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    • 1998
  • A most appropriate model of 3-D conformal radiotherapy has been induced by clinical evaluation and animal study, and therapeutic gains were evaluated by numerical equation of tumor control probability(TCP) and normal tissue complication probability (NTCP). The radiation dose to the tumor and the adjacent normal organs was accurately evaluated and compared using the dose volume histogram(DVH). The TCP and NTCP was derived from the distribution of given dosage and irradiated volume, and these numbers were used as the biological index for the assessment of the treatment effects. Ten patients with liver disease have been evaluated and 3 dogs were sacrificed for this study. Based on the 3-D images of the tumor and adjacent organs, the optimum radiation dose and the projection direction which could maximize the radiation effect while minimizing the effects to the adjacent organs could be decided. 3). The most effective collimation for the normal adjacent organs was made through the beams eye view with the use of multileaf collimator. When the dose was increased from 50Gy to 70Gy, the TCP for the conventional 2-port radiation and the 5-port multidimensional therapy was 0.982 and 0.995 respectively, while the NTCP was 0.725 and 0.142 respectively, suggesting that the 3-D conformal radiotherapy might be the appropriate therapy to apply sufficient radiation dose to the tumor while minimizing the damages to the normal areas of the liver. Positive correlation was observed between the NTCP and the actual complication of the normal liver in the animal study. The present study suggest that the use of 3-D conformal radiotherapy and the application of the mathematical models of TCP and NTCP may provide the improvements in the treatment of hepatoma with enhanced results.

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Morphologic Changes of the Pulmonary Arteries after Stent Implantation on Branch Pulmonary Artery Stenosis - Impact of Pulmonary Insufficiency - (폐동맥 분지협착에 스텐트 삽입 후 유발되는 폐동맥의 형태변화 - 폐동맥 폐쇄 부전의 역할 -)

  • Kim, Me Jin;Kang, Du Cheol;Choi, Jae Young;Lee, Jong Kyun;Sul, Jun Hee;Lee, Sung Kyu
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.67-75
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    • 2003
  • Purpose : Intravascular stent implantation for the treatment of postoperative branch pulmonary artery(PA) stenosis has been used successfully. However, the cross sectional area of contralateral branch PA does not regress in spite of the successful dilation of the stenotic branch PA after stent implantation. We analyzed the morphologic and hemodynamic factors on the size of branch PA after successful stent implantation. Methods : The subjects in our study were 23 children who had undergone stent implantaion from Jan. 1995 to Jul. 2002 in the Division of Yonsei Pediatric Cardiology. We evaluated the cross sectional area index(CSAI) of branch PA before and after stent implantation at follow-up catheterization. We also investigated factors such as residual pulmonary stenosis, pulmonary regurgitation(PR), systolic pressure of right ventricle, and lung perfusion scan. Results : The CSAI of the RPA without stenosis changed from mean $238{\pm}17mm^2/BSA$ to mean $249{\pm}20mm^2/BSA$(P=0.47), but didn't regress. The CSAI of the LPA with stenosis was increased effectively by stent implantation from the mean $102{\pm}12mm^2/BSA$ to mean $125{\pm}11mm^2/BSA$(P< 0.05). At follow up after stent implantation, the CSAI of PA is correlated with the residual PR fraction after stent implantation. Conclusion : In a group with increased residual PR, CSAI of RPA was found to be significantly increased between the pre- and post-stages of stent implantation. So, we suspect that the pulmonary regurgitation remaining after right ventricle outlet tract(RVOT) dilatation surgery is correlated with the increase in CSAI of RPA.

Analysis of cytosine adenine repeat polymorphism of the IGF-I promoter gene in children with idiopathic short stature (특발성 저신장증 환자에서 IGF-I 프로모터 cytosine-adenine repeat 유전자 다형성의 분석)

  • Moon, Jae Hoon;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.356-363
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    • 2009
  • Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature.

Infantile risk factors for obesity in preschool children (학령전기 소아비만에 영향을 주는 영유아기 인자)

  • Park, Sun Ju;Moon, Jae Won;Kim, Hyun Ji;Cho, Min Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.804-811
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    • 2008
  • Purpose : Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. Methods : A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. Results : There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. Conclusion : Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children.

Effects of the difference between actual body condition and body image perception on nutrient intake, weight control and mental health in Korean adults: Based on the 5th Korea National Health and Nutrition Examination Survey (한국 성인의 체질량 지수에 따른 비만도와 주관적 체형인식 간의 차이가 영양소 섭취와 체중조절 및 정신건강에 미치는 영향 : 제 5기 국민건강영양조사 자료를 이용하여)

  • Seo, Jihyun;Ma, Hyesun;Kim, Sunghee;Kim, Jiyoung;Shin, Minseo;Yang, Yoon Jung
    • Journal of Nutrition and Health
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    • v.49 no.3
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    • pp.153-164
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    • 2016
  • Purpose: The objective of this study was to examine the effect of the body shape discordance, the difference between true body type based on body mass index (BMI) and self-recognized body image, on nutrient intake, weight control attempt, and mental health in Korean adults. Methods: Subjects were persons aged 19~64 years (4,382 men and 6,226 women) who participated in the 2010~2012 Korea National Health and Nutrition Examination Survey. Subjects were categorized as RL (Group recognized as lighter than BMI criteria), RA (Group with agreement between BMI criteria and self-recognized body image), and RH (Group recognized as heavier than BMI criteria) according to the difference between actual body type based on BMI and self-recognized body image. Results: Means of BMI in RH groups were lower than or equal to that of RA groups in all groups. No significant differences in total energy intake were observed among the three groups in men, but total energy intake was higher in the RL group than in the RH group in 30~49 year old women. Proportion of carbohydrate was the highest in the RL group among 30~49 year old women. RH groups paid more attention to weight control and had less weight gain than other groups. Higher proportions of depressive symptoms were reported in the RH group in 19~29 year old men, while a higher proportion of depressive symptoms were reported in the RL group in 50~64 year old men. Conclusion: The current findings suggest an association of perceiving body shape with energy intake, weight control attempt, or depressed mood in some age groups. Body image perception can influence eating, weight control attempt, and depressed mood, therefore proper body image perception should be established in Korean adults.

Prevalence and Associated Factors of Snoring in School-Aged Children (학동기 아동에서 코골이의 유병률과 관련인자)

  • Cho, Sung Jong;Kim, Eun Young;Rho, Young Il;Yang, Eun Suk;Park, Young Bong;Moon, Kyung-Rye;Lee, Chul-Gab
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1340-1345
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    • 2002
  • Purpose : We studied the prevalence of snoring and its association with diseases, obesity and environmental factors, as well as sleep disturbance arising from snoring, in school-aged children. Methods : The survey was performed by a special questionnaire on 1,707 children at elementary schools from 1 to 30 July 2001 in Gwangju City. The prevalence of snoring, associated factors, and sleep disturbance were evaluated. Results : 266(16.5%) of the children snored at least once a week. 73(4.3%) of the children snored almost every day. Regarding the associated factors of snoring : There was a statistically significant difference between snoring and nonsnoring groups due to gender, obesity, sinusitis, tonsillar hypertrophy, bronchial asthma and allergic rhinitis. Of them, male gender, tonsillar hypertrophy, and obesity were significant risk factors for development of snoring. Especially, the odds ratio increased to 1.048(CI, 1.004-1.659), 1.748(CI, 1.175-2.599), and 2.266(CI, 1.300-3.950) in children with an obesity index of 20-29%, 30-49%, ${\geq}50%$, respectively. There was a statistically significant association of snoring with decreased sleep duration, sleep talking, and drowsiness during the day as a result of sleep disturbance. Conclusion : 16.5% of school-aged children snored at least once a week. The association of snoring with tonsillar hypertrophy, obesity and gender as risk factors was demonstrated in this study.

The Prevalent Rates of Abnormal Serum Aminotransferase Levels and Total Cholesterol Levels among Adolescents with Obesity (청소년기 비만아에서 이상 혈청 간효소치 및 총콜레스테롤치의 유병율)

  • Jang, Hyun Oh;Lee, Chong Guk;Kang, Yun Ju
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1484-1490
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    • 2002
  • Purpose : The purpose of this study was to look at prevalences of abnormal serum aminotransferase levels and abnormal serum total cholesterol levels among adolescents with obesity in Seoul area. Methods : Body mass index[$BMI(kg/m^2)$], serum aspartate aminotransferase(AST) alanine aminotransferase( ALT), and total cholesterol levels were measured in 26,876 adolescents(male : 13,287, female : 13,589) of first grade of high school in Seoul between the ages of 15 and 16 years, enrolled in a large health examination survey by Seoul School Health Center(SSHC) in 2001. Obesity was defined as BMI more than 95th percentile for age and sex and normal weight was defined as BMI between 25th percentile and 75th percentile for age and sex. Abnormal levels of AST, ALT and total cholesterol were defined as more than 95th percentile for age and sex. Results : The BMI at 95th percentile was 28.7 in males and 26.9 in females. The prevalence of abnormal AST levels was higher in obesity group than in normal weight group. In males, those were 23.7% and 3.7%, respectively(P<0.01, $x^2-value$ : 529.2). In females, those were 11.8% and 4.9 %, respectively(P<0.01, $x^2-value$ : 56.3). The prevalence of abnormal ALT levels was significantly higher in the obesity group compared with the normal weight group. In males, those were 33.9% and 1.7%, respectively(P<0.01, $x^2-value$ : 1,693.4). In females, those were 22.3% and 3.9%, repectively(P<0.01, $x^2-value$ : 397.6). The prevalence of abnormal total cholesterol levels was higher in the obesity group than in the normal weight group. In males, those were 16.8% and 3.5%, respectively(P<0.01, $x^2-value$ : 268.3). In females, those were 9.0% and 5.4%, respectively(P<0.01, $x^2-value$ : 14.2). Conclusion : This study revealed that the prevalences of abnormal AST, ALT and total cholesterol level were higher in the obese group than in the normal weight group.

A Nutrition Survey of the Rural Elderly in Hwaseung' Kyeonggi Province (일부농촌지역(一部農材地域) 노인(老人)들의 영양상태(營養狀態)에 관(關)한 연구(硏究))

  • Seo, Jung-Sook;Lee, Eun-Wha;Mo, Su-Mi
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.11 no.1
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    • pp.7-14
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    • 1982
  • A survey was carried out to determine the nutritional status of rural elderly. Determination was made on 50 persons, aged 60 years and over, in the rural area of Paltan-myeon, Hwaseong-kun, Kyeonggi province from June 1 to August 20, 1980. Grains provided 82$\sim$85% of total energy input most nutrient intake was from vegetable foods. Daily energy intake was not sufficient as 77.2$\sim$89.8% of RDA. The energy input percentage of carbohydrate: fat: protein was 79 : 10 : 11. showing higher dependance on carbohydrate. The protein intake only met 53.7$\sim$65.3% % of RDA. The contribution of animal proteins to total protein was only 12.2$\sim$12.4%, far below the recommended allowance. Both calcium and iron was insufficiently ingested as 40.6$\sim$55.7% and 72.0$\sim$92.0% of RDA, respectively. The intake of vitamin A and ascorbic acid almost reached RDA whereas the intake of thimin, riboflavin and niacin was not sufficient as 63.0$\sim$97.0%, 51.0$\sim$58.5% and 59.1$\sim$83.9% of RDA, respectively. 32% of the subjects were higher blood pressure than 160/95 mmHg proven to be hypertension. The correlation coefficients between clinical sign score, index of appetite, balance of meal and nutrient intake were significant. (P<0.05)

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Material Characteristics and Deterioration Assessment of the Stone Buddhas and Shrine in Unjusa Temple, Hwasun, Korea (화순 운주사 석조불감의 재질특성과 풍화훼손도 평가)

  • Park, Sung-Mi;Lee, Myeong-Seong;Choi, Seok-Won;Lee, Chan-Hee
    • Journal of Conservation Science
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    • v.24
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    • pp.23-36
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    • 2008
  • The stone Buddhas and Shrine of Unjusa temple (Korea Treasure No. 797) in Hwasun formed in Koryo Dynasty are unique style which the Buddha faces each other the back parts of south and north within the stone Shrine. The stone Buddhas and Shrine are highly evaluated in historical, artistic and academic respects. But, the stone properties have been exposed in the open system various aspects of degradations weathered for a long time without specific protective facilities. The rock materials of the stone Buddhas and Shrine are about 47 blocks, and total press load is about 56.6 metric ton. The host rocks composed mainly of white grey hyaline lithic tuff and rhyolitic tuff breccia. In addition, biotite granite used as part during the restoration works. The chemical index of alteration for host tuffaceous rocks and the replacement granites range from 52.1 to 59.4 and 50.0 to 51.0, respectively. Weathering types for the stone Buddhas and Shrine were largely divided with physical, chemical and biological weathering to make a synthetic deterioration map according to aspects of damage, and estimate share as compared with surface area. Whole deterioration degrees are represented that physical weathering appeared exfoliation. Chemical weathering is black coloration and biological weathering of grey lichen, which show each lighly deterioration degrees. According to deterioration degree by direction of stone Buddhas and Shrine, physical weathering mostly appeared by 39.1% on the sorthern part, and chemical weathering is 61.2% high share on the western part. Biological weathering showed 38.3% the largest distribution on the southern part. Therefore, it is necessary to try hardening for the parts with serious cracks or exfoliations, remove secondary contaminants and organisms through regular cleaning. Also necessary to make a plan to remove moisture of the ground which causes weathering, and estimate that need established and scientific processing through clinical demonstration of conservation plan that chooses suitable treatment.

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Growth promoting effect of combined gonadotropin releasing hormone analogue and growth hormone therapy in early pubertal girls with predicted low adult heights (예측성인신장이 작은 조기사춘기 여아에서 성선자극호르몬 방출호르몬 효능약제와 성장호르몬 병합치료의 성장획득 효과)

  • Hong, Eun-Jeong;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.678-685
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    • 2007
  • Purpose : Recent reports pointed out that gonadotropin releasing hormone analogue (GnRHa) therapy alone is not so promising for improving adult height in precocious puberty. So, that we studied the growth promoting effect of combined therapy with GnRHa and growth hormone (GH) in early pubertal girls. Methods : Twenty three early pubertal girls ($9.73{\pm}1.59yr$) with predicted adult heights (PAH) below-2 standard deviation score (SDS) were included. They were divided into two groups as follows; Group I before menarche (n=19) and Group II after menarche (n=4). After combined therapy, various growth parameters were compared between two groups and between the before and after therapy. Results : Between the two groups before therapy, chronologic age (CA), growth velocity (GV), body mass index (BMI), target height (TH), PAH and serum insulin-like growth factor binding protein-3 were not different, but BA, height and difference between bone age (BA) and CA were significantly higher and insulin-like growth factor-1 (IGF-1) was marginally higher in group II. After therapy, BA still remained higher in group II, but other parameters were not different. In both groups, after therapy, the difference between BA and CA, the ratio of BA over CA, and GV were significantly decreased, but PAH, height SDS and BMI were significantly increased. Regarding IGF-1 level, a significant increase was noted in group I, but not in group II. Conclusion : With combined therapy of GnRHa and GH, PAH in early pubertal girls might be improved significantly and even approach TH. Among them, those who were before menarche might have greater potential for the height gain than those after menarche in view of IGF-1 changes during therapy.