Purpose: This study was designed to investigate the dosimetric difference between intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) in head and neck cancer (HNC). The study primarily focuses on low-dose spillage evaluation between these two techniques. Methods: This retrospective study involved 45 patients with HNC. The treatment plans were generated using the IMRT and VMAT techniques for all patients. Dosimetric comparisons were performed in terms of target coverage, organ-at-risk (OAR) sparing, and various parameters, including conformity index, uniformity index, homogeneity index, conformation number, low-dose volumes, and normal tissue integral dose (NTID). Results: No significant (P>0.05) difference in planning target volume coverage (D95%) was observed between IMRT and VMAT plans for supraglottic larynx, hard palate, and tongue cancers. A decrease in dose volumes ranging from 1 Gy to 30 Gy was observed for VMAT plans compared with those for IMRT plans, except for V1Gy and V30Gy for supraglottic larynx cancer and V1Gy for tongue cancer. Moreover, decreases (P<0.05) in NTID were observed for VMAT plans compared with that for IMRT plans in supraglottic larynx (4.50%), hard palate (12.80%), and tongue (7.76%) cancers. In contrast, a slight increase in monitor units for VMAT compared with those for IMRT in supraglottic larynx (0.46%), hard palate (2.54%), and tongue (7.56%) cancers. Conclusions: For advanced-stage HNC, both IMRT and VMAT offer satisfactory clinical plans. VMAT offers a conformal and homogeneous dose distribution with comparable OAR sparing and higher dose falloff outside the target volume than IMRT, which provides an edge to reduce the risk of secondary malignancies for HNC over IMRT.
Byun, Kyung Do;Hwang, Hyo Jun;Park, Ki Jae;Kim, Min Chan;Cho, Se Heon;Ju, Mi Ha;Lee, Jin Hwa;Jeong, Jin Sook
Journal of Breast Cancer
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v.21
no.4
/
pp.406-414
/
2018
Purpose: T-cell immunoglobulin and mucin domain-containing molecule 3 (TIM-3) is an emerging immune response molecule related to T-cell anergy. There has been tremendous interest in breast cancer targeting immune checkpoint molecules, especially in the triple-negative breast cancer (TNBC). This study was designed to investigate TIM-3 expression on tumor infiltrating lymphocytes (TILs), its relationships with clinicopathological parameters and expression of programmed death receptor 1 (PD-1)/programmed death receptor ligand 1 (PD-L1), and its prognostic role. Methods: Immunohistochemistry on tissue microarray blocks produced from 109 samples of invasive ductal carcinoma type TNBC was performed with antibodies toward TIM-3, PD-1, PD-L1 and breast cancer-related molecular markers. Associations between their expression and clinicopathological parameters as well as survival analyses were performed. Results: TIM-3 was expressed in TILs from all 109 TNBCs, consisting of 17 cases (<5%), 31 cases (6%-25%), 48 cases (26%-50%), and 13 cases (>51%). High TIM-3 was significantly correlated with younger patients (p=0.0101), high TILs (p=0.0029), high tumor stage (p=0.0018), high PD-1 (p=0.0001) and high PD-L1 (p=0.0019), and tended to be associated with higher histologic grade, absence of extensive in situ components and microcalcification. High TIM-3 expression was significantly associated with a combinational immunophenotype group of high PD-L1 and high PD-1 (p<0.0001). High TIM-3 demonstrated a significantly better disease-free survival (DFS) (p<0.0001) and longer overall survival (OS) (p=0.0001), together with high TILs and high PD-1. In univariate survival analysis, high TIM-3 showed reduced relapse risk (p<0.0001) and longer OS (p=0.0003), together with high PD-1 expression. In multivariate analysis, high TIM-3 was statistically significant in predicting prognosis, showing better DFS (hazard ratio [HR], 0.0994; 95% confidence interval [CI], 0.0296-0.3337; p=0.0002) and longer OS (HR, 0.1109; 95% CI, 0.0314-0.3912; p=0.0006). Conclusion: In this study, we demonstrate that TIM-3 expression is an independent positive prognostic factor in TNBC, despite its association with poor clinical and pathologic features.
This study was focused on the recognition of historical values and the establishment of conservation schemes for a Silla stone monument in Bongpyeong-ri, Uljin by combining the humanistic investigation of inscription reinterpretation and the scientific conservational diagnosis of deterioration. According to the investigation of inscription, a total of 13 letters were reconsidered compared to the preceding researches. Thus, the meaning and interpretation of previous inscription was partially changed. This monument is composed of gneissose leucogranite and the most suitable site as provenance of the stone would be the Jukbyeon seashore (2.1km). The site shows similar color, size and composition of minerals, gneissose structure and magnetic susceptibility as the Bongpyeong stone monument. This monument developed a structural crack (crack index 0.4) and a microcrack (crack index 2.0) along the gneissose structure. The horizontal strength is weaker than the vertical strength. Therefore, the cracks should be reinforced and treated. However, consolidating is not urgently needed because the total weathering grade by ultrasonic velocity shows the stage of moderate weathering(3,403m/s, 0.32). Also, the major problems of chemical deterioration are blackening (85.2%) with soil, iron oxide,rubbing mark, and salt crystals (17.3%) from the sea. Therefore, the contaminants and the salt crystals should be removed using pressure spray and pulp paper, while the application of poultice should be examined through clinical tests.
Currently, liver transplantation is the only available remedy for patients with end-stage liver disease. Conservation of transplanted liver graft is the most important issue as it directly related to patient survival. Carbonyl reductase 1 (CBR1) protects cells against oxidative stress and cell death by inactivating cellular membrane-derived lipid aldehydes. Ischemia-reperfusion (I/R) injury during living-donor liver transplantation is known to form reactive oxygen species. Thus, the objective of this study was to investigate whether CBR1 transcription might be increased during liver I/R injury and whether such increase might protect liver against I/R injury. Our results revealed that transcription factor Nrf2 could induce CBR1 transcription in liver of mice during I/R. Pre-treatment with sulforaphane, an activator of Nrf2, increased CBR1 expression, decreased liver enzymes such as aspartate aminotransferase and alanine transaminase, and reduced I/R-related pathological changes. Using oxygen-glucose deprivation and recovery model of human normal liver cell line, it was found that oxidative stress markers and lipid peroxidation products were significantly lowered in cells overexpressing CBR1. Conversely, CBR1 knockdown cells expressed elevated levels of oxidative stress proteins compared to the parental cell line. We also observed that Nrf2 and CBR1 were overexpressed during liver transplantation in clinical samples. These results suggest that CBR1 expression during liver I/R injury is regulated by transcription factor Nrf2. In addition, CBR1 can reduce free radicals and prevent lipid peroxidation. Taken together, CBR1 induction might be a therapeutic strategy for relieving liver I/R injury during liver transplantation.
KIPS Transactions on Computer and Communication Systems
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v.10
no.10
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pp.285-290
/
2021
In the medical field, disease diagnosis and prediction research using artificial intelligence technology is being actively conducted. It is being released as a variety of products for disease diagnosis and prediction, which are most widely used in the application of artificial intelligence technology based on medical images. Artificial intelligence is being applied to diagnose diseases, to classify diseases into benign and malignant, and to separate disease regions for use in identification or reading according to the risk of disease. Recently, in connection with cloud technology, its utility as a service product is increasing. Among the diseases dealt with in this paper, liver disease is a disease with very high risk because it is difficult to diagnose early due to the lack of pain. Artificial intelligence technology was introduced based on medical images as a non-invasive diagnostic method for diagnosing these diseases. We describe the development of a web service to help the most meaningful clinical reading of liver cirrhosis patients. Then, it shows the web service process and shows the operation screen of each process and the final result screen. It is expected that the proposed service will be able to diagnose liver cirrhosis at an early stage and help patients recover through rapid treatment.
Introduction : Oral motor function is basic function of sensory exploration, feeding, and communication, that develops from the fetal stage to childhood. Problems with oral motor function result in difficulty within handling food in the oral cavity, decreased swallowing and feeding skills, difficulty with communication, and problems with oral hygiene. To treat these symptoms, oral motor therapy is provided for normalizing sensory adaptation in the oral cavity, and increasing postural control, oral movement and oral motor function. Discussion : The oral motor facilitation technique (OMFT) was developed for increasing general and integrated oral motor function based on the following: 1) understanding orofacial muscular physiology; 2) a comprehensive approach to sensory·adaptation·behavior·cognition; 3) sensorimotor stimulation by a manual approach; 4) motor control and motor learning theory. The OMFT is a new evidence-based treatment protocol, for children and adults with neuromuscular and oral motor problems. Conclusion : The goal of this article is to provide a theoretical background for OMFT development and the basic concept for the clinical application of OMFT. We hope that this article will help oral motor therapy experts to provide effective therapy in a more professional way.
Journal of Korean Society of Disaster and Security
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v.14
no.1
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pp.23-40
/
2021
In the era of the global coronal 19 pandemic, there is a risk of cross-infection in hospitals at the stage where treatments and vaccines are currently being developed and marketed, so individuals should enhance their acquired immunity and generalize their living systems by the performance of copper ions in the social environment. In order to prevent the spread of infection, the need for anti-bacterial film and its efficacy were analyzed through anti-viral performance tests based on research and development cases of worldwide and immemorial time. he Korea Construction Research Institute (KCL) has received anti-bacterial performance certification and anti-viral test scores from the "National Approval Performance Certification Agency." At the time, NCCP 43326 Human Corona virus (BetaCoV/Korea/KCDC03/2020), which was approved by the Centers for Disease Control and Prevention, was introduced to ensure that the activity rate of infected cells was satisfied in the anti-viral performance test. Anti-proliferation measures for the Corona 19 virus require a quality clinical trial study comparing the experimental group within the glass space where the antiviral copper film is constructed with the comparator of the same condition without copper film.
Purpose: Although dumping symptoms are thought to involve postprandial glycemic changes, postprandial glycemic variability without dumping symptoms remains poorly understood due to the lack of a method that allows the easy and continuous measurement of blood glucose levels. Materials and Methods: Patients having undergone distal gastrectomy with Billroth-I (DG-BI) or Roux-en-Y reconstruction (DG-RY), total gastrectomy with RY (TG-RY) and pylorus preserving gastrectomy (PPG) for gastric cancer 3 months to 3 years prior, diagnosed as pathological stage I or II, were prospectively enrolled from March 2018 to January 2020. The interstitial tissue glycemic levels were measured every 15 min, up to 14 days by continuous glucose monitoring. Moreover, using a diary recording the diet and symptoms, asymptomatic glucose profiles without sugar supplementation within 3 h postprandially were compared among the four procedures. Results: A total of 40 patients were enrolled, 10 patients for each of the four procedures. There were 47 glucose profiles with DG-BI, 46 profiles with DG-RY, 38 profiles with TG-RY, and 46 profiles with PPG. PPG showed the slowest increase with a subsequent gradual decrease in glucose fluctuations, without hyperglycemia or hypoglycemia, among the four procedures. In contrast, TG-RY and DG-RY showed spike-like glycemic variability, sharp rises during meals, and rapid drops. The glucose profiles of DG-BI were milder than those of RY. Conclusions: The asymptomatic glycemic changes after meals differ among the types of surgical procedures for gastric cancer. Given the mild glycemic fluctuations in PPG and the glucose spikes in TG-RY and DG-RY, pylorus preservation and physiological reconstruction without changes in food pathways may optimize postprandial glucose profiles after gastrectomy.
In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.
Objectives : The purpose of this study is to establish a Korean medical perspective on the human body through understanding of the meridians according to the distribution of the three yin and three yang (삼음삼양) and the opening, closing and pivot (관합추) as defined in ≪Huangdi's Internal Classic≫. Methods : A total of 8 medical databases including KISS, Earticle, DBpia, RISS, OASIS, KMbase, and ScienceON were used to search studies published through July 2021, and literature was included without limitations on the publication period. The search terms were "(meridian OR acupoint OR meridian sinew) AND position" OR "Gwan-Hap-Chu" OR "Gae-Hap-Chu" OR "three yin and three yang". Two researchers independently made choices among the searched literature based on the preplanned selection/exclusion criteria. The search terms were"(meridian OR acupoint OR meridian sinew) AND position" OR "Gwan-Hap-Chu" OR "Gae-Hap-Chu" OR "three yin and three yang". Results : Of the 36 obtained from the survey, 19 (53%) followed the definitions of "internal diameter" for "three yin and three yang" and "the opening, closing and pivot," but 6 (about 16%) took a neutral position and 10 (22%) avoided mentioning. Therefore, it was judged that research was needed to end the debate on the distribution of 'three yin and three yang' and 'the opening, closing and pivot'. In order to apply the definition of ≪Huangdi's Internal Classic≫ on 'distribution of the three-yin and three-yang' and 'the opening, closing and pivot' to the upper limb and lower limb as well as the torso of the human body, this author proposed a human body model with both upper limb and lower limb attached, inspired by the posture of the fetus in the developmental stage. Conclusions : In this study, using a new human body model, it was revealed that the distribution of the three yin and three yang and the opening, closing and pivot' as defined in the ≪Huangdi's Internal Classic≫ can be applied not only to the torso of the human body, but also to the upper limb and lower limb. Based on the understanding of meridians, the selection of meridians in the clinical acupuncture should be made accurately, and continuous interest and research on this are expected.
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