• Title/Summary/Keyword: surgery

Search Result 35,212, Processing Time 0.065 seconds

Comparison of Linac-based VMAT Stereotatic Radiosurgery and Conventional Stereotatic Radiosurgery for Multiple Brain Lesions (Linac 기반 VMAT 정위적 수술 뇌 병변 연구와 기존의 정위적 방사선 수술 비교)

  • Jang, Eun-Sung;Chang, Bo-Seok
    • Journal of the Korean Society of Radiology
    • /
    • v.15 no.2
    • /
    • pp.239-246
    • /
    • 2021
  • Portal Dosimetry was verified using EPID to secure the clinical application and reliability of the existing research dose evaluation. The dose distribution of Geant4 was compared with the measured value by 360° rotational irradiation with a 2.5 cm cone for stereotactic brain surgery. To confirm the dose distribution of patients with brain metastasis, the dose distribution investigated by inserting a Gafchromic EBT film into the parietal phantom and the dose distribution obtained from the parietal phantom using VMAT are compared and applied to actual patients. As a result of the analysis, it was confirmed that the accuracy of the beam center and the center of the couch coincide accurately with an error within 1mm as a result of QA through a pin ball. In addition, it was confirmed that the EBT3 film has excellent linearity in the range of 0 to 10 Gy according to various dose irradiation. In the same setting as the two cervical phantoms, we confirm that the implementation and simulation results calculations of dose calculations based on Geant4 using photon beams match the experimental data within the treatment planning volume (PTV). Therefore, volume modulated arc treatment (VMAT) 360° rotational irradiation was performed, and the result of iso-dose distribution analysis by rotational irradiation confirmed that it is appropriate to include a virtual tumor.

The Correlation Between Defense Mechanism and Posttraumatic Stress Disorder in Burn Patients (화상 환자의 방어기제와 외상후 스트레스 장애와의 관련성)

  • Lee, Dowon;Choi, Yanghwan;Kim, Jong Dae;Son, Kyung-Lak;Im, Woo Young;Jun, Jin Yong
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.29 no.2
    • /
    • pp.191-198
    • /
    • 2021
  • Objectives : This study was designed to investigate the correlation between defense mechanism and posttraumatic stress disorder in burn patients. Methods : We recruit 40 burn patients and we evaluate sociodemographic characteristics, characteristics related to burn, korean version of Impact of Event Scale-Revised (IES-R), Korean Version of Center for epidemiologic studies depression scale (CES-D) and Ewha Defense Mechanisms Test (EDMT). Multiple regression analysis was performed to evaluate the correlation between EDMT score and IES-R score. Results : Factor 2 of EDMT which consists of Ego-expansion subjects was significantly correlate with IER-S score. In factor 2, Controlling (β=-0.299, p<0.05), Sublimation (β=-0.276, p<0.05) is significantly correlate with IER-S score. Conclusions : Some subjects of defense mechanism was significantly correlate with IES-R score. it might be helpful to understand defense mechanism for the posttraumatic stress disorder in burn patients.

Psychiatric Manifestations of Anti-NMDA Receptor Encephalitis: A Case Report (항-NMDA 수용체 뇌염의 정신증상: 증례보고)

  • Kim, Hyunseuk;Lee, Haeyoung;Lee, Sang-Shin
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.29 no.2
    • /
    • pp.207-212
    • /
    • 2021
  • Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is a neuroinflammatory disease mediated by autoantibodies to NMDAR. In the initial clinical stages of anti-NMDAR encephalitis, psychiatric symptoms like delusions, perceptual disturbances, and disorganized speech or behaviors are pronounced even without obvious neurological symptoms. Early treatments like immunotherapy and/or tumor removal are central to good clinical outcomes. Hence, it is important to diagnose early anti-NMDAR encephalitis, distinguishing it from mental disorder. In the present case study, the authors described psychiatric symptoms assessed with Positive and Negative Syndrome Scale (PANSS) of Ms. A, a 26-year-old woman, in the early phase of anti-NMDAR encephalitis. We will discuss the characteristic psychopathology of anti-NMDAR encephalitis toward prompt diagnosis and treatment. Ms. A showed a higher negative subscale score than positive one on the PANSS. Compared with mental disorder, negative symptoms and cognitive impairment would be more prominent in the early stage of anti-NMDAR encephalitis. Rituximab and teratoma removal were effective, and quetiapine showed good tolerability. It is recommended to evaluate anti-NMDAR encephalitis when negative symptoms, cognitive impairment, catatonia, changes in consciousness level, and neurological symptoms are observed, especially in young women.

Alterations in Mitochondrial DNA Copy Numbers and Mitochondrial Oxidative Phosphorylation (OXPHOS) Protein Levels in Gastric Cancer Tissues and Cell Lines (위암 조직과 세포주에서 mDNA와 OXPHOS 단백질 분석)

  • Siregar, Adrian;Hah, Young-Sool;Moon, Dong Kyu;Woo, Dong Kyun
    • Journal of Life Science
    • /
    • v.31 no.12
    • /
    • pp.1057-1065
    • /
    • 2021
  • Alterations in mitochondrial DNA (mtDNA) copy numbers have been reported in patients with stomach cancer and suggested to play a role in gastric carcinogenesis or gastric cancer progression. However, changes in the levels of mitochondrial proteins or mtDNA-encoded oxidative phosphorylation (OXPHOS) proteins in gastric cancer remain unclear. In this study, we investigated mtDNA contents, mitochondrial protein levels, and mtDNA-encoded OXPHOS protein levels in gastric cancer tissues and cell lines. We correlated mtDNA copy numbers with clinicopathologic features of the gastric cancer samples used in this study and used quantitative PCR to analyze the mtDNA copy numbers of the gastric cancer tissues and cell lines. Western blot analysis was used for assessing the amounts of mitochondrial proteins and mtDNA-encoded OXPHOS proteins. Among the 27 gastric cancer samples, 22 showed a reduction in mtDNA copy numbers. The mtDNA content was increased in the other five samples relative to that in normal matched gastric tissues. Mitochondrial protein and OXPHOS protein levels were reduced in some gastric cancer tissues. However, mitochondrial protein and OXPHOS protein levels in gastric cancer cell lines were not always in line with their mtDNA contents. The mtDNA copy numbers were reduced in five gastric cancer cell lines tested in this study. In summary, this study reports a common reduction in mtDNA contents in gastric carcinoma tissues and cell lines, pointing to the possible involvement of mtDNA content alterations in tumorigenesis of the stomach.

Study of Correlation between Macular Thickness, Retina Nerve Fiber Layer Thickness and Axial Length according to Refractive Errors in Children (아동들의 굴절이상에 따른 안축장과 황반두께, 망막신경섬유층 두께의 상관성연구)

  • Choi, Hyung-Seok;Leem, Hyun-Sung
    • The Korean Journal of Vision Science
    • /
    • v.20 no.4
    • /
    • pp.421-429
    • /
    • 2018
  • Purpose : We identified correlation between macular thickness and RNFL (retina nerve fiber layer) measured by OCT and axial length in Korean children divided as three groups according to refractive errors. Methods : In total, 134 eyes of 67 Korean children who experienced no eye disease and ophthalmology surgery were involved in this study and then divided as three groups such as hyperopic, emmetropic and myopic groups. Macular thickness and RNFL thickness were measured with Cirrus HD-OCT, and axial length was done with IOL Master.Macular thickness and RNFL thickness were measured by Cirrus HD-OCT, and axial length using IOL Master. Correlation between axial length and retinal thickness in three groups according to refractive errors was investigated. Results : The type of refractive error measured by axial length was myopic, emmetropic and hyperopic groups in order, showing significant difference (p<0.05). The center thickness of macular was myopic, emmetropic and hyperopic groups in order, showing significant difference(p<0.05). The thicknesses of superior, nasal and inferior regions in peripheral macula were the thinnest in myopic group (p<0.05). It was shown that positive correlation was found between the center thickness of macula and axial length (r=0.283, p<0.05), while negative correlation was found between the peripheral thickness of RNFL and axial length. The temporal thickness of RNFL represented the thickest in myopic group, showing positive correlation with axial length(r=0.39, p<0.05). The superior, nasal and inferior thickness of RNFL represented negative correlation with axial length, showing statistically significant in the nasal thickness of RNFL(r=-0.23, p<0.05). Conclusion : Through this study, we identified correlation between macular thickness, the thickness of RNFL and axial length using OCT in Korean children, and also found the differences in three refractive error groups.

The Effect of Nicotine on the Proliferation and Differentiation of Normal Human Osteoblast at the Surface of Implants (임플란트 표면에서 배양된 정상인 조골세포의 증식 및 분화에 미치는 니코틴의 영향)

  • Ahn, Tae Woong;Lee, Chong Heon
    • The Korean Journal of Oral and Maxillofacial Pathology
    • /
    • v.42 no.5
    • /
    • pp.111-118
    • /
    • 2018
  • Nicotine of tobacco component has a controversial impact in the clinical outcome of dental implants. Although numerous nicotine effects on bone healing around implants have been presented, it is rarely reported in vitro study about normal human osteoblast(NHost) from oral and maxillofacial area at the surface of implants. The purpose of the present study was to evaluate the effect of nicotine on the proliferation and differentiation response of NHost to plasmatic and salivary levels of nicotine reported in smokers at the surface of screw-type plasma-sprayed titanium implants. NHosts were seeded on the surface of titanium implants and cultured for 21 days in ${\alpha}-MEM$ supplemented with 10% FBS, 50mg/ml ascorbic acid, 5mM ${\beta}$-glycerophosphate and 100nM dexamethasone. Seeded implants were exposed to various nicotine concentration(0.05-0.5mg/ml) from 1 to 21 days, and characterized for cell morphology, proliferation, differentiation, alkaline phosphatase(ALP) activity and ionized calcium concentration(Cai) of medium. Continuous exposure to higher nicotine concentration(above 0.3mg/ml) induced a dose- and time-dependent vacuolation of the cytoplasm, and a tendency to detach from the implant surface. 0.05mg/ml(lower nicotine concentration) did not cause significant effects in the cell proliferation and ALP activity. 0.1-0.2mg/ml caused evident dose-dependent effects in increased cell proliferation, ALP activity and earlier onset of matrix mineralization at levels up to 0.2mg/ml, while a dose-dependent inhibitory effect at 0.3-0.5mg/ml. Cai concentration of control group was decreased at 14 days. Increased Cai concentration at 0.1-0.2mg/ml, decreased Cai concentration at 0.3mg/ml and no change at 0.5mg/ml during the culture period were seen. It suggested that nicotine concentration could paly an role in modulating NHost activity as a contributing factor associated with proliferation and differentiation of NHost at the surface of implants.

Development of a Modified Disability Questionnaire for Evaluating Disability Caused by Backache in India and Other Developing Countries

  • Aithala, Janardhana P.;Kumar, Suraj;Aithal, Shodhan;Kotian, Shashidhar M.
    • Asian Spine Journal
    • /
    • v.12 no.6
    • /
    • pp.1106-1116
    • /
    • 2018
  • Study Design: Prospective observational study. Purpose: To evaluate the disability domains relevant to Indian patients with low backache and propose a modified disability questionnaire for such patients. Overview of Literature: The Oswestry Disability Index (ODI) is a self-reported measurement tool that measures both pain and functional status and is used for evaluating disability caused by lower backache. Although ODI remains a good tool for disability assessment, from the Indian perspective questions related to weight lifting and sexual activity of ODI are questioned in some of the earlier studies. Activities of daily living in Indian patients vary substantially from those in other populations and include activities like bending forwards, sitting in floor and squatting which are not represented in the ODI. Methods: In this prospective observational study, a seven-step approach was used for the development of a questionnaire. Thirty patients were interviewed to identify the most challenging issue they faced while performing their daily activities (by free listing) and understand how important the questionnaire items were in terms of the standard ODI. Thus, a comprehensive disability questionnaire comprising 14 questions was developed and administered to 88 patients. Both qualitative (interviews) and quantitative methods (to establish the validity, reliability, and correlation with the Visual Analog Scale [VAS] and Rolland Morris disability questionnaire) were used to identify the 10 questions that best addressed the disability domains relevant to Indian patients. Results: According to free listing, four new questions pertaining to bending forward, sitting on the floor, walking on uneven surfaces, and work-related disabilities were included. In the second phase, wherein the questionnaire with 14 items was used, 56.8% patients did not answer the questions related to sexual activity, whereas 23.8% did not answer those related to walking on uneven surfaces. The modified questionnaire demonstrated good internal consistency (Cronbach's alpha=0.892) and correlation with the Rolland Morris questionnaire (Cronbach's alpha=0.850, p>0.05), as well as with the VAS score for disability (Cronbach's alpha=0.712, p>0.05) and pain (Cronbach's alpha=0.625, p>0.05). Conclusions: A modified disability questionnaire that was designed by adding two questions related to bending forward and work status and removing questions related to sexual activity and weight lifting or traveling (depending on the occupation) can help evaluate disability caused by back pain in Indian population.

Comparison of Prognosis in Types 1 and 2 Papillary Renal Cell Carcinoma and Clear Cell Renal Cell Carcinoma in T1 Stage

  • Lee, Jaehoon;Chae, Han Kyu;Lee, Wonchul;Nam, Wook;Lim, Bumjin;Choi, Se Young;Kyung, Yoon Soo;You, Dalsan;Jeong, In Gab;Song, Cheryn;Hong, Bumsik;Hong, Jun Hyuk;Ahn, Hanjong;Kim, Choung-Soo
    • The Korean Journal of Urological Oncology
    • /
    • v.16 no.3
    • /
    • pp.119-125
    • /
    • 2018
  • Purpose: We compared subtypes of papillary renal cell carcinoma (pRCC; types 1 and 2) and clear cell renal cell carcinoma (ccRCC) in patients with T1-stage RCC to analyze the impact of the subtype on oncological outcomes. Materials and Methods: This paper reviewed 75 patients with pRCC and 252 patients with ccRCC at T1-stage from 1998-2012. Thus, we assessed the impact of subtype on oncologic outcomes among patients with T1-stage RCC. We used Kaplan-Meier analysis to estimate the overall survival and recurrence-free survival The median follow-up duration was 95 months (interquartile range, 75.4-119.3 months). Results: The 5-year recurrence-free survivals of pRCC and ccRCC were 95.4% and 97.6%, respectively. pRCC is worse than ccRCC in terms of recurrence-free survival (p=0.008) and there was no significant difference in the overall survival between pRCC and ccRCC (p=0.32). In addition, there was no significant statistical difference between type 1 pRCC and type 2 pRCC in terms of either recurrence-free survival (p=0.526) or overall survival (p=0.701). Age (hazard ratio [HR], 1.069; p<0.001) and recurrence (HR, 4.93; p<0.001) were predictors of overall survival. Only tumor size (HR, 1.071; p=0.004) was predictors in the case of cancer specific survival in the multivariate analysis. Conclusions: Among patients with T1-stage RCC, recurrence after surgery was more common in pRCC than ccRCC. The subtype of pRCC (types 1 and 2) had no impact on the recurrence-free survival or overall survival.

Factors Associated with Ruptured Intracranial Aneurysm in a Hospital (일개 병원의 뇌동맥류 파열의 위험요인)

  • Lee, En-Ha;Yun, So-Young;Choi, Ja-Yun
    • Journal of the Korea Convergence Society
    • /
    • v.10 no.1
    • /
    • pp.339-351
    • /
    • 2019
  • This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

A Survey of Nursing Practice Guidelines for Prevention of Pressure Injury in the Operating Room ([수술실] 욕창예방 간호 실무지침 현황 및 적용실태 조사)

  • Kim, Seung Ok;Shin, Yong Soon
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.19 no.11
    • /
    • pp.635-644
    • /
    • 2018
  • This descriptive study examined the practical nursing guidelines for the prevention of pressure injuries (PI) in operating rooms and their application. Method: Four general hospitals and three specialized hospitals located in Seoul, Incheon, and Gyeonggido province were selected through an online randomization program and nurses at these hospitals who participated in operations and had at least six months work experience were surveyed. Data were collected from January to April 2018 through a survey distributed to 150 nurses, 129 of whom returned the survey (86% recovery rate). The results showed that 43 nurses provided PI prevention care for patients in a lateral position (33.3%), 37 for patients in a supine position (28.7%), and 36 for patients in a prone position (27.9%). Gel was most widely used as the supporting surface material (102 nurses; 79.1%), followed by sponge (62 nurses; 48.1%), and cotton (47 nurses; 36.4%). Skin was often inspected twice, before and after the use of a supporting surface (90nurses; 69.8%), but no designated tool was used to determine the risk of PI developing (76 nurses; 58.9%). Additionally, the patient's position during surgery (83 nurses; 64.3%) and the length of the operation (i.e., more than two hours, in this case) (49 nurses; 38.0%) were determining factors for whether to use a supporting surface. The operating room nurses used the gel, sponge, and cotton as the supporting surfaces for the prevention of PI and confirmed that the cutoff operation time for the use of a supporting surface was more than 2 hours.