Kim KyoungTae;Ju SangGyu;Ahn JaeHong;Park YoungHwan
The Journal of Korean Society for Radiation Therapy
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v.16
no.2
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pp.81-89
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2004
Introduction : The setup error due to the patient and the staff from radiation treatment as the reason which is important the treatment record could be decided is a possibility of effect. The SET-UP ERROR of the patient analyzes the effect of dose distribution and DVH from radiation treatment of the patient. Material & Methode : This test uses human phantom and when C-T scan doing, It rotated the Left direction of the human phantom and it made SET-UP ERROR , Standard plan and 3mm, 5mm, 7mm, 10mm, 15mm, 20mm with to distinguish, it made the C-T scan error. With the result, The SET-UP ERROR got each C-T image Using RTP equipment It used the plan which is used generally from clinical - Box plan, 3Dimension plan( identical angle 5beam plan) Also, ( CTV+1cm margin, CTV+0.5cm margin, CTV+0.3,cm margin = PTV) it distinguished the standard plan and each set-up error plan and The plan used a dose distribution and the DVH and it analyzed Result : The Box4 the plan and 3Dimension plan which it bites it got similar an dose distribution and DVH in 3mm, 5mm From rotation error and Rectilinear movement( $0\%{\sim}2\%$ ). Rotation error and rectilinear error 7mm, 10mm, 15mm, 20mm appeared effect it will go mad to a enough change in treatment ( $2\%{\sim}^11\%$ ) Conclusion : The diminishes the effect of the SET-UP ERROR must reduce move with tension of the patient Also, we are important accessory development and the supply that it reducing of reproducibility and the move
Kim, Si-Ho;Lee, Young-Seok;Woo, Jong-Soo;Sung, Si-Chan;Choi, Pil-Jo;Cho, Gwang-Jo;Bang, Jung-Heui;Roh, Mee-Sook
Journal of Chest Surgery
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v.40
no.1
s.270
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pp.8-16
/
2007
Background: We performed a prospective clinical study to evaluate the ultrastructural integrity of the myocardium after using Histidine-Tryptophan-Ketoglutarate (HTK) solution in comparison with blood cardioplegic solution during congenital heart surgery. Material and Method: Twenty two patients with acyanotic heart disease, who were scheduled for elective open heart surgery, were randomized into two groups. The HTK Group (n=11) received HTK cardioplegic solution; the blood group (n=11) received conventional blood cardioplegic solution during surgery. The preoperative diagnoses included ventricular septal defect (n=9) and atrial septal defect (n=2) in each group. A small biopsy specimen was taken from the right ventricle's myocardium, and this was processed for ultrastructural examination at the end of 30 minutes of reperfusion. Semiquantitative electron microscopy was carried out 'blindly' in 4 areas per specimen and in 5 test fields per area by 'random systematic sampling' and 'point and intersection counting'. The morphology of the mitochondrial membrane and cristae were then scored. The interstitial edema of the myocardium was also graded. Result: The semiquantitative score of the mitochondrial morphology was $19.65{\pm}4.75$ in the blood group and $25.25{\pm}5.85$ in the HTK group (p=0.03). 6 patients (54.5%) in the blood group and 3 patients (27.3%) in the HTK group were grade 3 or more for the interstitial edema of the myocardium. Conclusion: The ultrastructural integrity was preserved even better with HTK solution than with conventional blood cardioplegic solution.
Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.
Choi Sukjin;Kim Hunjung;Song Eunseop;Kim Changyoung;Lee Meejo;Kim Woochul;Loh John J. K.
Radiation Oncology Journal
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v.23
no.2
/
pp.98-105
/
2005
Purpose : The objective of our study was to evaluate the immunohistochemical expression of p53 and bax proteins as prognostic markers in FIGO stage IIb invasive squamous cell carcinoma of the uterine cervix. Materials and Methods : Sixty-five cases of squamous cell carcinoma of the cervix (stage IIb) that were diagnosed from October 1995 to December 2003 were analyzed retrospectively for the bax and p53 expression. These expressions were determined immunohistochemically and they were correlated to the patients' overall survival and disease-free survival. Results : The overall 5-year survival (OS) rate and the disease-free survival (DFS) rate were $65.1\%$ and $62.9\%$, respectively. p53 and bax immunoreactivity was seen in $26.2\%$ and $52.3\%$ of cases, respectively, with variable levels of expression. On the univariate analysis, only p53 positivity correlated with poor survival in DFS (log-rank test p=0.027), but this significance was not maintained on multivariated analysis by Cox's regression. The nine cases with the immunophenotype ps3+/bax- had the poorest survival. Conclusion : Neither p53 nor bax expression are Independent predictors of the prognosis for stage IIb cervical squamous cancers. Evaluation of p53 and bax co-expression may affect the clinical outcome and further investigation is needed.
Two-demensional echocardiography is routinely used for evaluation of cardiac function. Visualization of the endocardial border is essential for the assessment of global and regional left ventricular with cardiac disease. SonoVue$^{TM}$ is a microbubble contrast agent that consists of sulfur hexafluoride-filled microbubbles in a phospholipid shell. There were many studies about contrast echocardiographic examination using SonoVue$^{TM}$ contrast agent, and various doses of SonoVue$^{TM}$ were used. To our knowledge, in published veterinary medicine, there was not reported for diagnostic efficient dose of SonoVue$^{TM}$ to evaluate contrast enhanced left ventricular endocardial border delineation (LVEBD). The purpose of this study is to compare the visualization time of LVEBD and find efficient dose of SonoVue$^{TM}$ for using various doses in dogs. Ten healthy Beagles were recruited to the study. Three different doses (0.03 ml/kg, 0.05 ml/kg and 0.1 ml/kg) of SonoVue$^{TM}$ were injected. Endocardial segments were assigned based on previously established methodology, where by the four-chamber views of the LV were divided into 6 segments. In this study, Contrast enhancement of the LVEBD after each injection was evaluated visually at the time point of overall contrast enhancement (Segmental scoring 5+) in the LV by three investigators in a blind manner. Statistical analysis was performed with SPSS version 14.0. All data were analyzed using one-way ANOVA, the multiple comparison Scheffe test. When data for the three offsite readers were combined, mean durations of useful contrast were $3.54({\pm}2.14)$, $6.15({\pm}2.61)$, and $24.39({\pm}11.10)$ seconds for the 0.03 ml/kg, 0.05 ml/kg, and 0.1 ml/kg SonoVue$^{TM}$ doses, respectively. After injection of contrast agent, there were no significant change in side effects such as urticaria, angioedema, hypersensitivity reactions, and digestive system disorders. This study suggests that efficient dose of SonoVue$^{TM}$ contrast agent for improvement of the left ventricle visualization is 0.1 ml/kg. The duration of useful enhancement of LVEBD and the reproducibility were also the highest at the 0.1 ml/kg dosage.
Kim, Jung Mi;Choe, Byung-Ho;Jang, You Cheol;Oh, Ki Won;Cho, Min Hyun;Lee, Kyung Hee;Park, Jin-Young;Kim, Heng Mi
Clinical and Experimental Pediatrics
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v.49
no.7
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pp.737-744
/
2006
Purpose : To assess the usefulness of $^{99m}Tc-DISIDA$ scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the final diagnosis and the results of DISIDA scanning were analyzed by scatter plots using the parameters of age and the level of liver function tests(direct bilirubin, AST, ALT, ALP, GGT). The diagnostic sensitivity, specificity and accuracy of DISIDA scanning in the diagnosis of biliary atresia were compared between a higher bilirubin group and a lower bilirubin group(direct bilirubin level >5 mg/dL vs. <5 mg/dL) decided by the pattern of scatter plots. Results : DISIDA scannings in the diagnosis of biliary atresia were analyzed by high sensitivity(100 percent, 16/16) but lower specificity(70.4 percent, 50/71) and accuracy(75.9 percent, 66/87). False positivity(29.6 percent, 21/71) was higher in patients with a higher direct bilirubin level(42.5 percent for >5 mg/dL vs. 9.7 percent for <5 mg/dL, P<0.01). The age and the level of liver function tests(AST, ALT, ALP, GGT) analyzed by scatter plots revealed neither diagnostic value in predicting final diagnosis nor estimated the accuracy rate of DISIDA scanning in the evaluation of neonatal cholestasis. Conclusion : We suggest that DISIDA scannings should not be routinely used in evaluating neonatal cholestasis with elevated direct bilirubin level(>5 mg/dL), especially if it delays early diagnosis and surgical intervention.
Purpose: Ursodeoxycholic acid (UDCA) is known to decrease hepatic injury by promoting the biliary secretion of retained toxic endogenous bile acids in hepatobiliary diseases complicated by total parenteral nutrition (TPN). However, most studies have focused on treatment for complications after TPN. We investigated the preventive role of early administration of UDCA in TPN-induced hepatobiliary complications by a randomized, double-blind, placebo-controlled trial. Methods: Between May 2000 and May 2002, thirteen patients, who were given TPN more than 10 days in the hospital, were assigned randomly to two groups. One was the case group (7 patients) who were given UDCA simultaneously with TPN regimen, and the other, the control group (6 patients) who were given placebo. Their age ranged from 1 day to 13 years. They were affected with diseases impossible for enteral nutrition, such as prematurity, cerebral palsy, chronic diarrhea, anorexia nervosa, pancreatitis, and cyclic vomiting. The duration of TPN ranged from 10 to 70 days. Hematologic parameters including liver function test were measured at regular intervals, and the duration, composition, administration rate, total calorie of TPN were recorded. The serum levels of total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase were compared between groups after cessation of the study. Results: The autoregressive coefficient of the control group was 0.4419 (p=0.0651) in bilirubin, -0.0431 (p=0.7923) in AST, 0.2398 (p=0.2416) in ALT, and 0.2459 (p=0.1922) in alkaline phosphatase by mixed procedure model when the parameters were referred to the case group. Conclusion: The serum level of total bilirubin did not increase in comparison with that of the control group, but statistically insignificant, when both TPN and UDCA were administered simultaneously from the beginning.
Purpose During Brain SPECT study, critical factor for proper study with $^{99m}Tc-ECD$ or $^{99m}Tc-HMPAO$ is one of the important causes to patent's movement. It causes both improper diagnosis and examination failure. In this study, we evaluated the effect of Dynamic Continuous Mode Acquisition compared to Step and Shoot Mode to raise efficacy and reject the data set with movement, as well as, be reconstructed in certain criteria. Materials and Methods Deluxe Jaszczak phantom and Hoffman 3D Brain phantom were used to find proper standard data set and exact time. Step and Shoot Mode and Dynamic Continuous Mode Acquisition were performed with SymbiaT16. Firstly, Deluxe Jaszczak phantom was filled with $Na^{99m}TcO_4$ 370 MBq and obtained in 60 minutes to check spatial resolution compared with Step and Shoot Mode and Dynamic Continuous Mode. The second, the Hoffman 3D Phantom filled with $Na^{99m}TcO_4$ 74 MBq was acquired for 15 Frame/minutes to evaluate visual assessment and quantification. Finally, in the Deluxe Jaszczak phantom, Spheres and Rods were measured by MI Apps program as well as, checking counts with the frontal lobe, temporal lobe, occipital lobe, cerebellum and hypothalamus parts was performed in the Hoffman 3D Brain Phantom. Results In Brain SPECT Study, using Dynamic Continuous Mode rather than current Step and Shoot Mode, we can do the reading using the 20 to 50 % of the acquired image, and during the test if the patient moves, we can remove unneeded image to reduce the rate of restudy and reinjection. Conclusion Dynamic Continuous Mode in Brain study condition enhances effects compared to Step and Shoot Mode. And also is powerful method to reduce reacquisition rate caused by patient movement. The findings further indicate that it suggest rejection limit to maintain clinical value with certain reconstruction factors compared with Tomo data set. Further examination to improve spatial resolution, SPECT/CT should be the answer for that.
Purpose: The purpose of this study was to provide the basic information on the improvement plan by identifying the role accomplishment and job satisfaction of the hospice nurses and analyzing the factors that impact such role accomplishment and job satisfaction. Methods: The data was collected of 189 hospice nurses who have been working more than 6 months in 56 hospice programs registered in Korea Hospice Association and Korean Catholic Hospice Association from October to November, 2007 by structured questionnaire which was developed by Ryu(1979), based on the Riehl's nursing role and the research of Choe(2005) on the role of hospice nurse. Results: The role accomplishment and job satisfaction of the study subject were 3.53 point and 3.39 point, respectively. The roles of hospice nurses were accomplished by the order of advocator, nursing care provider, coordinator (cooperation), educator, quality manager, counsellor, administrator, and researcher. The job satisfaction of the hospice nurses was shown highest in the satisfaction of professional status, followed by the satisfaction of the interaction, satisfaction of the task itself, satisfaction of the administrative aspect, satisfaction of the autonomous, and the lowest in the satisfaction of the pay. The role accomplishment of the subjects according to their socio-demographic and job characteristics was found to have a significant difference by their age, marriage status, academic background, and position. It also has a significant difference by whether they play role of coordinator, whether they took whole responsibility as hospice, working experience as hospice/palliative nurse, and the level of hospice/palliative nursing training(p<.05). In the study of job satisfaction of the subjects according to their socio-demographic and job characteristics, the job satisfaction was found to have a significant difference by the increase of age, the number of duties consisting the hospice team, whether they play role of coordinator, whether they take whole responsibility as hospice, the level of hospice/palliative nursing training, and whether they wish to work for as long as possible(p<.05). The role accomplishment and the job satisfaction of the subjects showed a statistically significant positive correlation. (r=.541, p<.01) Conclusion: Raised saiary will be increased hospice nurse's job satisfaction. And we suggest a repetitive study using the identical tool to the equally extracted subjects with same representativeness of each hospice/palliative institute type. For the expanded role and enhanced professional standard of hospice nurses, we also suggest a study on the improvement plan to enhance the roles of researcher and administrator.
Kim, You Na;Lee, Jin Ah;Kim, Jae Yong;Kim, Myoung Joon;Tchah, Hung Won
Journal of The Korean Ophthalmological Society
/
v.59
no.11
/
pp.1017-1023
/
2018
Purpose: A recently introduced phacoemulsification system, the WhiteStar $Signature^{(R)}$ PRO, has demonstrated improved nucleus followability and cutting efficiency via an improved pump regulator with a higher reaction response and an automatic occlusion sensing system. In this study, we compared various phacoemulsification parameters between the new system and an older version of the device. Methods: A total of 80 eyes of 68 patients with cataracts who had undergone phacoemulsification by a single surgeon were included in this study. Forty eyes of patients underwent phacoemulsification using the older $Signature^{(R)}$ system (WhiteStar); these patients were classified as the control group. Another 40 eyes of patients underwent phacoemulsification with the newer enhanced system, the WhiteStar $Signature^{(R)}$ PRO; these patients were assigned to the experimental group. During the operation, operative parameters, including the effective phaco time (parameter of effective phaco time with a specific coefficient for the transversal movement expressed in seconds, EFX), ultrasound time (seconds [s]), effective phacoemulsification time (EPT, s), average phacoemulsification power (AVG, %), and balanced salt solution usage, were measured to determine the performance enhancement offered by the updated system. Central corneal thickness was measured before and after surgery to compare corneal edema. The relationships between the two groups were analyzed using an independent t-test. Results: The Signature $PRO^{(R)}$ system showed a lower EFX (p < 0.001), a shorter EPT (p < 0.001), and a smaller AVG (p < 0.001). Postoperative corneal thickness did not differ significantly between the two groups. Conclusions: Comparing the efficacy of the improved reaction speed of the device and automatic occlusion sensing system in performing phacoemulsification, the updated Signature $PRO^{(R)}$ system demonstrated superior followability and cutting efficiency regardless of nuclear cataract hardness.
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