• Journal of radiological science and technology
• /
• v.35 no.4
• /
• pp.327-333
• /
• 2012

Purpose: To analyze the correlation between dose volume histograms(DVH) based on organ outer wall contour and organ wall delineation for bladder and rectum, and to compare the doses to these organs with the absorbed doses at the bladder and rectum. Material and methods: Individual CT based brachytherapy treatment planning was performed in 13 patients with cervical cancer as part of a prospective comparative trial. The external contours and the organ walls were delineated for the bladder and rectum in order to compute the corresponding dose volume histograms. The minimum dose in 0.1 $cm^3$, 1 $cm^3$, 2 $cm^3$, 5 $cm^3$, 10 $cm^3$ volumes receiving the highest dose were compared with the absorbed dose at the rectum and bladder reference point. Results: The bladder and rectal doses derived from organ outer wall contour and computed for volumes of 2 $cm^3$, provided a good estimate for the doses computed for the organ wall contour only. This correspondence was no longer true when large volumes were considered. Conclusion: For clinical applications, when volumes smaller than 5 $cm^2$ are considered, the dose-volume histograms computed from external organ contours for the bladder and rectum can be used instead of dose -volume histograms computed for the organ walls only. External organ contours are indeed easier to obtain. The dose at the ICRU rectum reference point provides a good estimate of the rectal dose computed for volumes smaller than 2 $cm^2$ only for a midline position of the rectum. The ICRU bladder reference point provides a good estimate of the dose computed for the bladder wall only in cases of appropriate balloon position.

• Korean Journal of Clinical Laboratory Science
• /
• v.49 no.4
• /
• pp.407-412
• /
• 2017

The aim of this study was to shorten the time required for subculture and bacterial identification and obtain a simple and rapid identification method for new test methods for bloodstream infections. The following results were obtained using a mass spectrometer. In Vitek 2, 208 (81.8%) cases were well-identified and 45 isolates were not identified in blood cultures. Among 208 cases, 146 (57.5%) were Gram positive bacteria and 108 (42.5%) were Gram negative bacteria. In total, 233 were identified to the species level and 21 were identified to the genus level. The identification error was found to be Propionibacterium acnes as Clostridium bifermentans. The accuracy of Enterobacteriaceae, glucose non-fermentative bacilli (GNFB), and staphylococci were 81/83 (97.6%), 12/15 (80.0%), and 72/85 (84.7%), respectively. The concordance rate of Vitek 2 and Vitek MS by the direct method was 81.8% and 45 isolates were not identified. Most of the unidentified bacteria were Gram positive bacteria (N=37). The Gram positive bacteria were streptococci (14), coagulase-negative staphylococci (CNS) (11), enterococci (3), Staphylococcus aureus (2), Micrococcus spp. (2), Bacillus spp. (2) and Actinomyces odontolyticus, Finegoldia magna, and Peptostreptococcus spp. The results reporting time was reduced to 24~72 hours compared to the conventional method. The rate of identification of the aerobic and anaerobic cultures was similar, but the use of an anaerobic culture did not require a dissolution process, which could shorten the sample preparation time. These results suggest that the method of direct identification in blood cultures is very useful for the treatment of patients. In further studies, it might be necessary to further improve the method for identifying streptococci and CNS, which were lacking in accuracy in this study.

• Pediatric Infection and Vaccine
• /
• v.13 no.2
• /
• pp.106-114
• /
• 2006

Purpose : Studying the serotypes and emm genotype of group A streptococci(GAS) hold a key role in the investigation of epidemiology, pathogenesis, and resistance to antibiotics. We planed to find out the possible differences in serotypes and genotypes between the invasive and the non-invasive GAS infection. Methods : We obtained 39 isolates from the patients hospitalized in 2004 with the diagnosis of invasive GAS infectious diseases in the Severance Hospital, Yonsei University. We sent the isolates to the WHO Collaboratory Center in University of Minnesota and analyzed T serotypes and emm genotypes. These results were compared with non-invasive GAS infections in our hospital. Results : Compared this data with the results of 2003 to 2004, T2/28, T3, T5/27/44, T9 and NT were more prevalent. The NT showed statistically significant difference(P=0.019). The emm 3, emm 9, emm 18, emm 44 and emm provision type STG485 were more frequent genotypes compared with the study in 2003~2004, relatively. The emm provision type STG485 had statistically significant difference(P=0.000). The incidence of T12 plus T4, known as erythromycin(EM) resistant serotypes, was as low as 17.9% in this study, compared with those of non-invasive strains. Conclusion : The incidence of EM-resistant strains is supposed not to be higher in invasive GAS infection. We could find out possible higher incidence of rheumatogenic strains in the invasive GAS infections. It seems to be important to have an effort on studying of serotyping and genotyping for the monitoring of strains and to know the epidemiologic characteristics.

• Pediatric Infection and Vaccine
• /
• v.16 no.2
• /
• pp.150-161
• /
• 2009

Purpose : Staphylococcus aureus causes a variety of infections, ranging from benign skin infections to fatal invasive infections. Recently, methicillin-resistant S. aureus (MRSA) infections have emerged in patients who do not have established risk factors. This study was conducted to characterize S. aureus infections in children with an emphasis on communityassociated MRSA infections at a tertiary care pediatric facility during a 3-year period. Methods : Four hundred twenty-nine cases of S. aureus infections diagnosed at the Seoul National University Children's Hospital between January 2004 and December 2006 were retrospectively reviewed. The cases were classified as hospitalonset (HO) or community-onset (CO), healthcare-associated (HA), or community-associated (CA) infections. Results : Among the 206 cases <1 year of age, 72%, 7%, and 21% were HO-HA, CO-HA, and CA infections, respectively, as compared to 48%, 28%, and 24% among the 223 cases >1 year of age. The proportion of CO-HA infections among HA infections (8.6% vs. 37.1%, P<0.001) and the proportion of HA infections among the CO infections (24.5% vs. 54.3%, P <0.001) were greater in older children than in infants. Overall, 57% of the isolates were methicillin-resistant. Twenty-nine (30%) of 96 CA strains were MRSA, and the most common site of CA-MRSA infection was the skin and soft tissues (26 cases). Conclusion : The methicillin resistance rate of S. aureus from CA infections was high and CA-MRSA was most often associated with skin and soft tissue infections.

• Journal of Preventive Medicine and Public Health
• /
• v.35 no.3
• /
• pp.245-254
• /
• 2002

Objective : To test if the intake of $H_2$ receptor antagonists ($H_2$-RAs) increases the risk of gastric cancer in the elderly. Methods : The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1999. The information on $H_2$-RAs exposure was obtained from a drug prescription database compiled between inn. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. Results : After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 195% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). Conclusion : The intake of $H_2$-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.

• Radiation Oncology Journal
• /
• v.26 no.2
• /
• pp.96-103
• /
• 2008

Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

• Journal of the Korean Society of Radiology
• /
• v.8 no.5
• /
• pp.241-248
• /
• 2014

The purpose of this study were to analyze the clinical correlation between the thyroid autoimmune antibodies (anti-TPO Ab, anti-TG Ab, and TSH) and the maximum standardized uptake value ($SUV_{max}$) base on the Hashimoto's thyroiditis and the Graves' disease in diffusely $^{18}F-FDG$ uptake of the thyroid gland to the PET/CT image. To achieve this, we was performed the PET/CT examination for the 1,097 subjects from May 2010 to April 2013 in the health screening, and was detected the diffused FDG thyroid uptake, and was additionally performed the thyroid function test (TFT) and the ultrasound (US). As a results, the autoimmune thyroid disease with the diffused FDG thyroid uptake were discovered 39 patients (3.9%), of this, the Hashimoto's thyroiditis was 43.6% and the Graves' disease was 23.1%. Hashimoto's thyroiditis was shown the positive reaction of high titer between the anti-TPO Ab and the anti-TG Ab level, and the correlation coefficient between the $SUV_{max}$ and the anti-TPO Ab was a statistically significant (r>04, p<0.05). Also, Graves' disease was shown the positive reaction of high titer most of the thyroid autoimmune antibodies, and the correlation coefficient between the $SUV_{max}$ and the anti-TPO Ab was a statistically significant (r>05, p<0.01). Therefor, when have a high standard of the $SUV_{max}$ due to the diffusely $^{18}F-FDG$ uptake of the thyroid gland, Hashimoto's thyroiditis and Graves' disease were proportionally increased the anti-TPO Ab and TSH level, respectively. The correlation coefficient between the $SUV_{max}$ and the thyroid autoimmune antibodies will be the most influential criterion that was a standard of judgment for the epihpenomenon of the autoimmune thyroid disease, and it will be available for the clinical application.

• Journal of Hospice and Palliative Care
• /
• v.7 no.2
• /
• pp.200-213
• /
• 2004

Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.2
• /
• pp.113-126
• /
• 2002

Background : DNA repair plays a crucial role in protection from cancer-causing agents. Therefore, a reduced DNA repair capacity can increase the susceptibility to lung cancer. The XPC gene contains 15 exons and encodes a 940 amino acid protein that plays a central role in DNA damage recognition of the nucleotide excision repair pathway, which is a major DNA repair mechanisim removing the bulky-helix distorting DNA lesions caused by smoking. Recently several polymorphisms in the XPC gene were identified. In addition, it is possible that these polymorphisms may affect the DNA repair capacity, which modulate cancer susceptibility. The relationship between codon 499 and 939 polymorphisms, and a poly(AT) insertion/deletion polymorphism in the XPC gene, and the lung cancer risk were investigated. Materials and Methods : The genotypes were determined using either PCR or PCR-RFLP analysis in 219 male lung cancer patients and 150 healthy males controls. Results : The frequencies of the genotypes (Val499Ala, PAT and Lys939Gln) among the cases were not significantly different from those of the controls. There was no significant associantion between these polymorphi는 and the lung cancer risk when the analyses were stratified according to age, smoking status and the pack-years of smoking. Moreover, the genotypes had no apparent relationship with any of the histological types of lung cancer. There was a linkage disequilibrium among the Val499Ala, PAT and Lys939Gln polymorphisms. The PAT polymorphism had a strong linkage disequilibrium with the Lys939Gln polymorphism (kappa value=0.87). The XPC haplotypes showed no significant association with the lung cancer risk. Conclusion : These results suggest that XPC Val499Ala, PAT and Lys939Gln polymorphisms are not major contributors to the individual lung cancer susceptibility in Koreans.

• Journal of Sasang Constitutional Medicine
• /
• v.7 no.2
• /
• pp.59-88
• /
• 1995

Three groups have participated in this study. 1) The first group consists of 57 patients were who had been treated in the Oriental Medical Hospital at Kyung Hee Medical Center. 2) The second group consists of 37 outpatients who had been treated in the Oriental Medical Hospital at Kyung Hee Medical Center. 3) The third group consists of 76 students of the Oriental Medical School at Kyung Hee University. The following conclusions were made in comparison with EAV measurement values, SaSang Constitution Classfication and CVA. 1. The following conclusions were made in comparison with EAV measurement values and Type(SaSang Constitution Classfication). 1) The analsis of the Correlation in Normal group with EAV measurement values and Type(SaSang Constitution Classfication). 2) The analysis of the correlation in patient group with EAV measurement values showed significant differences in Right meridians(Nerval degeneration vessel, Circulation, Allergy) and in Left meridian(Liver). 3) The analysis of the correlation in Total(Normal+patient)group with EAV measurement values showed significant differences in Right meridians(Large intestine, Nerval degeneration vessel, Circulation, Allergy, Pancreas) and in Left meridians(Lymph vessel, Nerval degeneration vessel, Spleen, liver). 4) The above results showed common-significant differences in Right Allery meridian and in Left Liver meridian. 2. The analysis of the correlation in EAV measurement values and Group (Cerebrovascular accident) showed significant differences in Right meridians(Lymph vessel, Lung, Nerval degeneration vessel, Allergy, Paren & Epith. degeneration vessel, Triple warmer, Heart, Pancreas, Stomach, Fibroid degeneration vessel, Skin, Fatty degeneration vessel, Heart, Stomach, Fibroid degeneration vessel, Skin, Fatty degeneration vessel, Bile duct, Kidney). 3. The analysis of the correlation in EAV measurement values and Para(GROUPS according to PARALYSIS)showed significant differences in Left Stomatch meridian. The analysis of the correlation in EAV measurement values and Para(GROUPS according to PARALYSIS) about the differance of right measurement values and left measurement values showed significant differences in Nerval degeneration vessel, Stomatch, Gall bladder & Bile duct, Kidney and Urinary Bladder meridians. 4. The analysis of the correlation in EAV measurement values and Compl(GROUPS according to COMPLICATION with CVA)showed significant differences in Right meridians(Lymph vessel, Articular degeneration vessel, Fatty degeneration vessel) and in Left meridians(Lung, Stomatch, Fatty degeneration vessel). 5. The analysis of the correlation in Type and MORPHOROGICAL DIAGRAMING (HTOUPS according to MORPHOROGY) showed significant differences in Cranium region, Chest region, Stomatch region and Umbilicum region. 6. The analysis of the correlation in BAZ measurement values and Group(Cerebral Vascular Attack)showed significant differences, the analysis on the correlation of BAZ measurement values and Type(SaSang Constitution Classfication) didn't show any significant differences. 7. In comparison with Actual measurement vales and Voll's measurement values, BAZ measurement values agree with Voll's measurement values but CMP measurement values lower than the Voll's measurement values. Later We have to research further about classifications of race, age, sex etc. The EAV measurement values have Group(Cerebrovascular accident) more correlative than Type(SaSang Constitution Classfication). The EAV may well be that it will be used as an accessory method in SaSang Constitution Classfication and as a diagnostic method in medicine too.