• 제목/요약/키워드: patient-specific

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Generation of Renal Cell Carcinoma-specific CD4+/CD8+ T Cells Restricted by an HLA-39 from a RCC Patient Vaccinated with GM-CSF Gene-Transduced Tumor Cells

  • Jun, Do Youn;Moutner, Joseph;Jaffee, Elizabeth
    • IMMUNE NETWORK
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    • 제3권2호
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    • pp.96-102
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    • 2003
  • Background: Granulocyte-macrophage colony-stimulating factor (GM-CSF) gene-transduced tumor cell vaccines induce very potent systemic anti-tumor immunity in preclinical and clinical models. Our previous phase I clinical trial in patients with metastatic renal cell carcinoma (RCC) has demonstrated both immune cell infiltration at vaccine sites and T cell-mediated delayed-type hypersensitivity (DTH) response to whole tumor cell vaccines. Methods: To investigate the immune responses to autologous genetically- modified tumor cell vaccines, tumor-specific $CD8^+$ T cell lines were generated from peripheral blood lymphocytes (PBL) of a RCC patient 1.24 by repeated in vitro stimulation with either B7.1-transduced autologous RCC tumor cells or B7.1-transduced autologous tumor cells treated with interferon gamma ($IFN{\gamma}$), and cloned by limiting dilution. Results: Among several RCC-specific cytotoxic T lymphocytes (CTLs), a $CD4^+/CD8^+$ double positive T cell clone (17/A2) appeared to recognize $IFN{\gamma}$-treated autologous RCC restricted by HLA-B39. The 17/A2 also recognized other HLA-B39 positive RCC tumor cells after $IFN{\gamma}$ treatment. Conclusion: These results demonstrate that autologous RCC vaccination successfully generates the tumor-specific CTL 17/A2, and suggest that the presentation and recognition of the tumor antigen by the 17/A2 might be upregulated by $IFN{\gamma}$.

CT 영상을 이용한 3D 프린팅으로 환자 맞춤형 대퇴골 첨삭가공 (Additive Manufacturing of Patient-specific Femur Via 3D Printer Using Computed Tomography Images)

  • 오왕균;임기선;이태수
    • 한국방사선학회논문지
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    • 제7권5호
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    • pp.359-364
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    • 2013
  • 대퇴골은 사람의 뼈 중 가장 길며 체중을 지탱하는 골격체로 대퇴골간은 긴 파이프 모양이면서 안에 해면골이 거의 없어서 골절이 발생되면 재생이 어렵다. 사고로 인하여 발생되는 대퇴골의 골절은 골간부가 가장 높은 빈도로 발생한다. 골절의 수술방법은 골수강에 IM Nail을 삽입하여 골절부위를 고정하는 IM Nailing이다. 수술 시 대퇴골의 중심으로 진입하지 못하면 2차 골절 등의 피해가 발생하기도 한다. 본 연구에서는 수술 전 대퇴골의 CT IMAGE을 이용하여 3D 프린터로 환자 맞춤형 대퇴골을 제작하여 골수강으로 IM Nailing 시뮬레이션을 할 수 있도록 하였다. 수술 중 발생할 수 있는 2차적 손상을 방지 하고 시간 단축, 정밀한 수술을 할 수 있을 것이다.

Positive and Negative Effects of IT on Cancer Registries

  • Mohammadzadeh, Niloofar;Safdari, Reza;Rahimi, Azin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4455-4457
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    • 2013
  • In the new millennium people are facing serious challenges in health care, especially with increasing non-communicable diseases (NCD). One of the most common NCDs is cancer which is the leading cause of death in developed countries and in developing countries is the second cause of death after heart diseases. Cancer registry can make possible the analysis, comparison and development of national and international cancer strategies and planning. Information technology has a vital role in quality improvement and facility of cancer registries. With the use of IT, in addition to gaining general benefits such as monitoring rates of cancer incidence and identifying planning priorities we can also gain specific advantages such as collecting information for a lifetime, creating tele medical records, possibility of access to information by patient, patient empowerment, and decreasing medical errors. In spite of the powerful role of IT, we confront various challenges such as general problems, like privacy of the patient, and specific problems, including possibility of violating patients rights through misrepresentation, omission of human relationships, and decrease in face to face communication between doctors and patients. By implementing appropriate strategies, such as identifying authentication levels, controlling approaches, coding data, and considering technical and content standards, we can optimize the use of IT. The aim of this paper is to emphasize the need for identifying positive and negative effects of modern IT on cancer registry in general and specific aspects as an approach to cancer care management.

Practical Implementation of Patient-Specific Quality Assurance for Small and Multiple Brain Tumors in CyberKnife with Fixed Collimators

  • Lee, Eungman;Park, Kwangwoo;Kim, Jin Sung;Kim, Yong Bae;Lee, Ho
    • 한국의학물리학회지:의학물리
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    • 제29권2호
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    • pp.53-58
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    • 2018
  • This paper evaluates patient-specific quality assurance (PSQA) in the treatment of small and multiple tumors by the CyberKnife system with fixed collimators, using an ion chamber and EBT3 films. We selected 49 patients with single or multiple brain tumors, and the treatment plans include one to four targets with total volumes ranging from 0.12 cc to 3.74 cc. All PSQA deliveries were performed with a stereotactic dose verification phantom. The A16 microchamber (Standard Imaging, WI, USA) and Gafchromic EBT3 film (Ashland ISP Advanced Materials, NJ, USA) were inserted into the phantom to measure the point dose of the target and the dose distribution, respectively. The film was scanned 1 hr after irradiation by a film digitizer scanner and analyzed using RIT software (Radiological Imaging Technology, CO, USA). The acceptance criteria was <5% for the point dose measurement and >90% gamma passing rate using 3%/3 mm and relative dose difference, respectively. The point dose errors between the calculated and measured dose by the ion chamber were in the range of -17.5% to 8.03%. The mean point dose differences for 5 mm, 7.5 mm, and 10 mm fixed cone size was -11.1%, -4.1%, and -1.5%, respectively. The mean gamma passing rates for all cases was 96.1%. Although the maximum dose distribution of multiple targets was not shown in the film, gamma distribution showed that dose verification for multiple tumors can be performed. The use of the microchamber and EBT3 film made it possible to verify the dosimetric and mechanical accuracy of small and multiple targets. In particular, the correction factors should be applied to small fixed collimators less than 10 mm.

Utilization of desktop 3D printer-fabricated "Cost-Effective" 3D models in orthognathic surgery

  • Narita, Masato;Takaki, Takashi;Shibahara, Takahiko;Iwamoto, Masashi;Yakushiji, Takashi;Kamio, Takashi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.24.1-24.7
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    • 2020
  • Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

Computational analysis of the electromechanical performance of mitral valve cerclage annuloplasty using a patient-specific ventricular model

  • Lee, Kyung Eun;Kim, Ki Tae;Lee, Jong Ho;Jung, Sujin;Kim, June-Hong;Shim, Eun Bo
    • The Korean Journal of Physiology and Pharmacology
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    • 제23권1호
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    • pp.63-70
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    • 2019
  • We aimed to propose a novel computational approach to predict the electromechanical performance of pre- and post-mitral valve cerclage annuloplasty (MVCA). Furthermore, we tested a virtual estimation method to optimize the left ventricular basement tightening scheme using a pre-MVCA computer model. The present model combines the three-dimensional (3D) electromechanics of the ventricles with the vascular hemodynamics implemented in a lumped parameter model. 3D models of pre- and post-MVCA were reconstructed from the computed tomography (CT) images of two patients and simulated by solving the electromechanical-governing equations with the finite element method. Computed results indicate that reduction of the dilated heart chambers volume (reverse remodeling) appears to be dependent on ventricular stress distribution. Reduced ventricular stresses in the basement after MVCA treatment were observed in the patients who showed reverse remodeling of heart during follow up over 6 months. In the case who failed to show reverse remodeling after MVCA, more virtual tightening of the ventricular basement diameter than the actual model can induce stress unloading, aiding in heart recovery. The simulation result that virtual tightening of the ventricular basement resulted in a marked increase of myocardial stress unloading provides in silico evidence for a functional impact of MVCA treatment on cardiac mechanics and post-operative heart recovery. This technique contributes to establishing a pre-operative virtual rehearsal procedure before MVCA treatment by using patient-specific cardiac electromechanical modeling of pre-MVCA.

Patient-specific Guides Using 3-dimensional Reconstruction Provide Accuracy and Reproducibility in Reverse Total Shoulder Arthroplasty

  • Yoon, Jong Pil;Kim, Dong Hyun;Jung, Jae Wook;Lee, Chang-Hwa;Min, Seunggi;Lee, Hyun Joo;Kim, Hee-June
    • Clinics in Shoulder and Elbow
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    • 제22권1호
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    • pp.16-23
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    • 2019
  • Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components. Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image. Results: The superoinferior and anteroposterior offset in the glenoid component were $0.42{\pm}0.07$, $0.50{\pm}0.08$ in the conventional group and $0.45{\pm}0.03$, $0.46{\pm}0.02$ in the PSG group. The inclination and version angles were $-1.93^{\circ}{\pm}4.31^{\circ}$, $2.27^{\circ}{\pm}5.91^{\circ}$ and $0.46^{\circ}{\pm}0.02^{\circ}$, $3.38^{\circ}{\pm}2.79^{\circ}$. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were $0.45{\pm}0.12$, $0.48{\pm}0.15$ in the conventional group and $0.46{\pm}0.59$ (p=0.794), $0.46{\pm}0.06$ (p=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment. Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.

우리는 얼굴을 어떻게 평가하는가? (What Do We See When We Look at Faces?)

  • Evans, Carla A.
    • 대한치과교정학회지
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    • 제33권5호
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    • pp.319-322
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    • 2003
  • Recent scientific findings on the perception of facial attractiveness coupled with technological advances in computer imaging make it possible to measure the facial characteristics that nay be associated with specific judgments of facial appearance. These new methods can be used to produce psychometric norms of facial attractiveness which potentially could supplement the conventional population norms or averages used currently in orthodontic treatment planning. It is hypothesized that consideration of psychometric norms will enhance doctor-patient communication and lead to greater patient satisfaction at the completion of orthodontic treatment.

심미보철물의 임상적 원리 (Clinical Principles in Esthetic Restoration)

  • 이종엽
    • 대한심미치과학회지
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    • 제8권1호
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    • pp.10-17
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    • 1999
  • Replacements for natural dentition must fulfil many criteria. An important aspect, especially for the patient, is aesthetic consideration. The shape and colour can be important factors in the aesthetic success of an anterior restoration. In order to allow for proper shape; the outline form, the spatial position of individual teeth and the surface characteristics must be considered. For the colour; translucency, value, chroma and hue must be expressed exactly. The dentist and technicians should catch up these very specific characteristics of the patient and convert them accurately to the restorations with the simplest way.

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폐에 발생한 원발성 융모막 상피종 치험 1례 (One Case Report of Primary Choriocarcinoma of the Lung)

  • 김기만
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.366-369
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    • 1990
  • Primary choriocarcinoma of the lung is extremely rare. The patient was 28-year-old female and had no specific signs and symptoms except right chest pain for 5 years. On simple chest film, 8X8 cm sized, well demarcated, homogeneous ovoid mass was found on right lower lung field. The qualitative urine \ulcorner-HCG was 17140 mIU/ml. The result of percutaneous needle biopsy highly suggested choriocarcinoma. Under the impression of primary choriocarcinoma of the lung, right middle and lower lobectomy was done. On 33 postoperative days, serum \ulcorner-HCG level was within normal limit, the patient was discharged without complications after one-cycle chemotherapy.

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