Radiobiological and physical effects of patient setup errors during whole breast irradiation

Background: The dose-related effects of patient setup errors on bio-physical indices were evaluated for the conventional wedge [CW] and field-in-field [FIF] whole breast irradiation techniques [WBI]

Materials and Methods: The treatment plans of 10 patients receiving left WBI were retrospectively selected for evaluation. The bio-physical effects of dose variations were evaluated by shifting the isocenters and gantry-angles of the treatment plans. Dose-volume histograms of the planning target volume [PTV], heart, and lungs were generated, and the conformity index [Cl], homogeneity index [HI], tumor control probability [TCP], and normal tissue complication probability [NTCP] were determined

Results: The D95 of the PTV for an [isocenter shift plan] with a posterior direction decreased by approximately 15%, and the TCP of the PTV decreased by approximately 50% for the FIF technique and by 40% for the CW; however, the NTCPs of the lungs and heart increased for both techniques. Increasing the gantry-angle decreased the TCPs of the PTV by 24.4% [CW] and by 34% [FIF]. The NTCPs of the lungs and heart for the two techniques differed by only 3%. The CIs and His for the CW case were higher than the corresponding values obtained for the FIF case. Significant differences were observed between the two techniques [p<0.01]

Conclusion: Our results revealed that the biophysical properties of the FIF case were more sensitive to setup errors than those in the CW case. The radiobiological-based analysis could be detected significant dosimetric errors and provided a practical patient quality assurance method for guiding the bio-physical effects?

Fundamental Principles in Aesthetic Rhinoplasty

This review article will highlight several fundamental principles and advances in rhinoplasty. Nasal analysis has become more sophisticated and thorough in terms of breaking down the anomaly and identifying the anatomic etiology. Performing this analysis in a systematic manner each time helps refine these skills and is a prerequisite to sound surgical planning. Dorsal augmentation with alloplastic materials continue to be used but more conservatively and often mixed with autogenous grafts. Long term outcomes have also taught us much with regards to wound healing and soft tissue contracture. This is best demonstrated with a hump reduction where the progressive pinching at the middle vault creates both aesthetic and functional problems. Correcting the twisted nose is challenging and requires a more aggressive intervention than previously thought. Both cartilage and soft tissue appear to have a degree of memory that predispose to recurrent deviations. A complete structural breakdown and destabilization may be warranted before the nose is realigned. This must be followed by careful and meticulous restabilization. Tip refinement is a common request but no single maneuver can be universally applied; multiple techniques and grafts must be within the surgeon's armamentarium.

Optimization of operational parameters for ethanol production from Korean food waste leachate

Recently, research on the production of ethanol from waste has been accelerating for both ecological and economical reasons, primarily for its use as an alternative to petroleum based fuels. In this study, response surface methodology based 2[3] -full factorial central composite design was employed to optimize the parameters of ethanol production from Korean food waste leachate. The reducing sugar concentration of the food waste leachate determined by the dinitrosalicylic acid method was 75 g/L. A second order polynomial model was developed to evaluate the quantitative effects of temperature, pH and reducing sugar concentration in order to find an optimum condition for the ethanol production from food waste leachate. From the experimental result, maximum ethanol concentration of 24.17 g/L was obtained at the optimum condition of temperature [38°C], pH [5.45] and reducing sugar concentration [75 g/L]. The experimental value [24.17 g/L] agreed very well with the predicted one [23.66 g/L], indicating the suitability of the model employed and the success of response surface methodology in optimizing the conditions of ethanol production from food waste leachate. Canonical analysis indicated that the stationary point was a saddle point for the ethanol yield. Despite being a waste, an ethanol yield of 0.32 g ethanol/g reducing sugar demonstrated the potential of food waste leachate as a promising biomass resource for the production of ethanol

Development and Application of Participatory Action Oriented Training(PAOT) for Improvement of Agricultural Working Environment in Korea / 農村醫學 地域保健

OBJECTIVES: This study was conducted to develop a Korean version of the Participatory Action Oriented Training (PAOT) program and training materials for improvement of agricultural working environments. METHODS: The PAOT manual and checklist were developed on the basis of the original English version of the training materials, a questionnaire survey of agricultural health and safety professionals, and a brainstorming conference. Good example pictures were collected through visits to agricultural workers' houses, and an easily understandable picture was drawn by an animation specialist. A PAOT action manual and five types of action checklists were developed for use in different agricultural environments. Each action checklist contained six categories and 38 items of agricultural health and safety principles; the six categories were material storage and handling, work stations and tools, machine safety, physical environment, working schedule and organization, and basic health and safety management. Incorporating these training materials, a one-day Korean PAOT program was developed. RESULTS: Among 307 candidate agricultural workers from four rural Korean villages, 94 workers (59 males, 35 females) participated in a PAOT from July 2007 to Oct 2008. The PAOT program was successful and the mean self-estimated satisfaction score of the participants was greater than 90%. CONCLUSIONS: A Korean PAOT program and training materials were successfully developed and applied to Korean agricultural workers. Although more studies are needed, it is expected that PAOT will greatly contribute to the improvement of agricultural working conditions and health and safety through the use of agricultural workers' self initiatives.

Influence of dissolved oxygen concentration and aeration time on nitrite accumulation in partial nitrification process

This study investigated the influence of dissolved oxygen concentration and aeration time on nitrification and nitrite accumulation in an attempt to optimize the recently developed biological-partial-nitritation process for the treatment of strong nitrogen wastewaters. Investigation of dissolved oxygen concentration on ammonium and nitrite oxidation was carried out in a batch reactor. The dissolved oxygen concentration of 0.5 mg O2/L inhibited both ammonium as well as nitrite oxidation, while increase of dissolved oxygen concentration to tilde1 mg O2/L increased the ammonium oxidation rate and was comparable to that at higher dissolved oxygen concentrations. Experiments were carried out in a sequencing batch reactor for more than 100 days to investigate the influence of aeration time on nitrite accumulation. The dissolved oxygen concentration was controlled at tilde1.0 mg O2/L [in the range of 0.8-1.5 mg/L] during the aeration stage, and volatile suspended solid was maintained at 2.0 g/L while temperature and pH were 30 +/- 1§C and 8.3 +/- 0.1, respectively. In a typical cycle, complete nitrification occurred at aeration time longer than 6 h. When the aeration time was reduced to 4 h., tilde80% of partial nitritation was achieved. With a further reduction in aeration time to 3 h., nearly 1:1 nitrite/ammonium ratio was yielded. This result revealed that for the reactor design, aeration time determined by feasibility experiments must be considered based on the nitrogen strength in wastewater and biomass concentration in the reactor with dissolved oxygen concentration of tilde1.0 mg O2/L for satisfactory partial nitrification with subsequent processes such as anaerobic ammonium oxidation

intelligent neural network model for evaluating performance of immobilized cell biofilter treating hydrogen sulphide vapors

Biofiltration has shown to be a promising technique for handling malodours arising from process industries. The present investigation pertains to the removal of hydrogen sulphide in a lab scale biofilter packed with biomedia, encapsulated by sodium alginate and poly vinyl alcohol. The experimental data obtained under both steady state and shock loaded conditions were modelled using the basic principles of artificial neural networks. Artificial neural networks are powerful data driven modelling tools which has the potential to approximate and interpret complex input/ output relationships based on the given sets of data matrix. A predictive computerised approach has been proposed to predict the performance parameters namely, removal efficiency and elimination capacity using inlet concentration, loading rate, flow rate and pressure drop as the input parameters to the artificial neural network model. Earlier, experiments from continuous operation in the biofilter showed removal efficiencies from 50 to 100% at inlet loading rates varying up to 13 g H2S/m[3]h. The internal network parameter of the artificial neural network model during simulation was selected using the 2[k] factorial design and the best network topology for the model was thus estimated. The results showed that a multilayer network [4-4-2] with a back propagation algorithm was able to predict biotilter performance effectively with R[2] values of 0.9157 and 0.9965 for removal efficiency and elimination capacity in the test data. The proposed artificial neural network model for biofilter operation could be used as a potential alternative for knowledge based models through proper training and testing of the state variables

Nasal Reconstruction in the 21st Century: A Contemporary Review

Nasal restoration in the 21st century has reached a new milestone that has brought together centuries of experiences, lessons, errors, and rewards. The bar has been set and it is nothing less than a restoration of normal function and complete social acceptance. The aesthetic expectations of both minor and major nasal repair include symmetry, natural contour, excellent color and texture match, and a final product that remains inconspicuous to the casual observer. The major tenets that have been realized today include the wide application of the subunit principle, liberal and nonanatomic cartilage grafting (for form and function), and addressing each of the three layers of the nose independently. Anticipating resultant scars and vectors of tension during wound healing are the subtle nuances of nasal reconstruction that ensure a pleasing result. The robust nature of the forehead flap has proven to be a workhorse for major nasal resurfacing.

Nasal Reconstruction in the 21st Century: A Contemporary Review

Nasal restoration in the 21st century has reached a new milestone that has brought together centuries of experiences, lessons, errors, and rewards. The bar has been set and it is nothing less than a restoration of normal function and complete social acceptance. The aesthetic expectations of both minor and major nasal repair include symmetry, natural contour, excellent color and texture match, and a final product that remains inconspicuous to the casual observer. The major tenets that have been realized today include the wide application of the subunit principle, liberal and nonanatomic cartilage grafting (for form and function), and addressing each of the three layers of the nose independently. Anticipating resultant scars and vectors of tension during wound healing are the subtle nuances of nasal reconstruction that ensure a pleasing result. The robust nature of the forehead flap has proven to be a workhorse for major nasal resurfacing.

Blood Glucose Change and the Impact of Participation in Diabetes Mellitus Class of a Public Health Center / 農村醫學 地域保健

OBJECTIVES: Recently the care of cerebrovascular and cardiovascular disease is important as much as that of cancer care in public health, so the control of diabetes mellitus(DM) which is a risk factor of cerebrovascular and cardiovascular disease has been also important consideration. This study was carried out to investigate the blood glucose change of the participants in diabetes mellitus class(DM class) of a health center. METHODS: Study subjects were 54 participants of DM class in a health center that had been held once a month, from January 2005 to March 2006. RESULTS: Among the DM class participants, 67.3% participated by 50% or over in the DM class. After DM class, the level of random blood sugar decreased from 176mg/dl to 156mg/dl in DM class participants(p<0.05). In a comparison between more than 50% participation group and less than 50% participation group, more than 50% participation group got decreased level of blood sugar from 182mg/dl to 155mg/dl and less than 50% participation group also got decreased level from 172mg/dl to 156mg/dl. But there was no statistically significant difference between two groups. CONCLUSION: DM class of health center was effective program to manage diabetes mellitus patients in community.

Statistical analysis of main and interaction effects during the removal of BTEX mixtures in batch conditions using wastewater treatment plant sludge microbes

Biodegradation has proved to be a versatile technique to remediate benzene, toluene, ethyl benzene and xylene [BTEX] mixtures in contaminated soil and groundwater. In this study, a mixed microbial culture obtained from a wastewater treatment plant was used to degrade liquid phase BTEX, at initial concentrations varying between 15 to 75 mg/l. Experiments were conducted according to the 2k-1 fractional factorial design to identify the main and interaction effects of parameters and their influence on biodegradation of individual BTEX compounds in mixtures. The removal efficiencies of these compounds varied between 2 to 90% depending on the concentration of other compounds and also on their interaction effects. A statistical interpretation of the results was done based on the Fishers variance ratio [F] and probability [P] values. Though all the main effects were found significant [P < 0.05] at the 5% confidence level, the interactions between benzene and toluene and benzene and xylene concentrations were also found to be statistically significant and play a major role in affecting the total BTEX removal

Central Core Disease: A Case Report

Central core disease is a rare autosomal dominantly inherited non-progressive congenital myopathy, which is pathologically characterized by the formation of a "core". We report a 28-year-old female with non-progressive muscle weakness, who had a hypotonic posture at birth. The developmental milestones were delayed with her first walking at 18 months of age. She could not run or walk a long distance and weight-bearing tasks were almost impossible. None of her family members showed motor symptoms. An investigation of the electromyography and nerve conduction velocity showed non-specific results. A gastrocnemius muscle biopsy revealed central cores in approximately 70% of myofibers with a type 1 myofiber predominance and deranged sarcolemmal structures. To the best of our knowledge, this is the fifth report of central core disease in the Korean literature.

Influence of Estrogen and Polyamines on Mifepristone-induced Apoptosis in Prostate Cancer Cells / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Although androgens are the main steroids controlling the growth of prostate glands, estrogens are also important in the regulation of its growth. Prostate cancer cells, like other cancer cells, maintain high levels of polyamines. In LNCaP cells, apoptosis is induced by mifepristone. During the process of cell death, the regulation of ROS production, caspase-3 activation and poly (ADP-ribose) polymerase cleavage were investigated in the presence of estrogen and polyamines to identify their possible roles. MATERIALS AND METHODS: The cell growth was assessed using the MTT assay, and the intracellular ROS production by the DCFH-DA assay. The p53 protein expression, activation of caspase-3 and PARP cleavage were checked by Western blotting, with specific antibodies to each. RESULTS: The growth and viability of the cells were significantly inhibited, in a dose- and time-dependent manners, by mifepristone (MIF) treatment. The production of ROS were dependent on the MIF dosage. The activation of caspase-3 and cleavage of PARP also increased with the duration of MIF treatment. The expression of p53 protein also increased with increases in the MIF incubation time. E2 severely inhibited the ROS production, caspase-3 activation and PARP cleavage. However, polyamines only inhibited the ROS production, without influencing the caspase-3 activation or PARP cleavage. CONCLUSION: In LNCaP cells, MIF induces apoptosis through ROS production. The expression of p53 protein, caspase-3 activation and PARP cleavage accompanied the process of apoptosis. The apoptotic processes were inhibited by E2, but polyamines only inhibited the ROS production, implying the multifunctional role of E2, in addition to its role as a free radical scavenger.

Endometrial Mucinous Adenocarcinoma with Extensive Squamous Differentiation: A Case Report

Endometrial mucinous adenocarcinoma occurs in 1-9% of endometrial adenocarcinomas and adenocarcinoma with squamous differentiation in approximately 25%. We report a rare case of mucinous adenocarcinoma with squamous differentiation in a 53-year-old woman. Curetting biopsies of the endometrial lesion were taken twice after hormone replacement therapy, which lasted for four months. Because the squamous differentiation was so extensive, the initial diagnosis based on each curetting specimen was squamous papilloma. A total hysterectomy was performed and the tumor was revealed to be a mucinous adenocarcinoma with squamous differentiation. We subsequently discussed the pathogenesis and prognosis of this type of tumor.

Estimation of Cell Concentration by Light Transmitter During the Culture of Methylotrophic Yeast Pichia pastoris

The multiple correlation coefficient between the values determined by dry weight and those determined by fluorometer was observed with r = 0.96 and the standard error of calibration was 0.034. Using the best calibration data, in order to reconfirm the reliability of the fluorometer results in comparison with those obtained by dry weight on the cell concentration, fedbatch cultures were carried out. The results obtained by fluorometer measurements were in good agreement with those obtained by dry weight. The on-line monitoring of cell concentration by the fermentor system linked to a computer equipped with fluorometer was successfully carried out.

Malignant Peripheral Nerve Sheath Tumor in Descending Colon: A Case Report

We report a unique case of malignant peripheral nerve sheath tumor (MPNST) of colon, not associated with neurofibromatosis or parasite infection. The tumor presented as an encircling mass in descending colon causing obstruction with nuberous metastatic lesions in a 43-year-old man. The tumor was largely composed of spindle cells which showed strong positivity for vimemtin, S-100 protein and Leu-7. The tumor often exhibited epithelioid feature where tumor cells were weakly positive for cytokeratin.

A retrospective comparison of four different procedures for extracting dermoid cyst by laparoscopy / 대한산부인과학회잡지

OBJECTIVES: To compare results of 4 different extraction methods in laparoscopic management of dermoid cyst. STUDY DESIGN: This article is a retrospective, multicenter study for 247 patients with benign dermoid cyst in period of 1995-1998. Dermoid cyst was extracted by Endopouch (99 cases), puncture-irrigation-extraction (69 cases), colpotomy (35 cases), and dermoid cyst as a "pouch bag" (44 cases). RESULTS: We analyzed irrigation amount, operative time, postoperative hospital stay and complications by four different extraction methods. Endopouch extraction method needed less amount of irrigation fluid for cleaning the abdominal cavity and had a shorter postoperative hospital stay (ANOVA, p=0.0001). There were no significant differences in operative times among groups. There were four cases of morbidity in puncture-irrigation-extraction method (6%), three had fever (> 38degrees C) and one intraabdominal abscess. One incisional hernia was noted in "pouch bag" method (2%). CONCLUSIONS: We recommend minimal spillage method for extraction of dermoid and careful irrigation of abdominal cavity to prevent potential risk of chemical peritonitis such as Endopouch, "pouch bag", and colpotomy with the exception of puncture-irrigation-extraction method.

Human FEN-1 can process the 5'-flap DNA of CTG/CAG triplet repeat derived from human genetic diseases by length and sequence dependent manner

Trinucleotide repeat (TNR) instability can cause a variety of human genetic diseases including myotonic dystrophy and Huntington's disease. Recent genetic data show that instability of the CAG/CTG repeat DNA is dependent on its length and replication origin. In yeast, the RAD27 (human FEN-1 homologue) null mutant has a high expansion frequency at the TNR loci. We demonstrate here that FEN-1 processes the 5'-flap DNA of CTG/CAG repeats, which is dependent on the length in vitro. FEN-1 protein can cleave the 5'-flap DNA containing triplet repeating sequence up to 21 repeats, but the activity decreases with increasing size of flap above 11 repeats. In addition, FEN-1 processing of 5'-flap DNA depends on sequence, which play a role in the replication origin-dependent TNR instability. Interestingly, FEN-1 can cleave the 5'-flap DNA of CTG repeats better than CAG repeats possibly through the flap-structure. Our biochemical data of FEN-1's activity with triplet repeat DNA clearly shows length dependence, and aids our understanding on the mechanism of TNR instability.

Human FEN-1 can process the 5'-flap DNA of CTG/CAG triplet repeat derived from human genetic diseases by length and sequence dependent manner

Trinucleotide repeat (TNR) instability can cause a variety of human genetic diseases including myotonic dystrophy and Huntington's disease. Recent genetic data show that instability of the CAG/CTG repeat DNA is dependent on its length and replication origin. In yeast, the RAD27 (human FEN-1 homologue) null mutant has a high expansion frequency at the TNR loci. We demonstrate here that FEN-1 processes the 5'-flap DNA of CTG/CAG repeats, which is dependent on the length in vitro. FEN-1 protein can cleave the 5'-flap DNA containing triplet repeating sequence up to 21 repeats, but the activity decreases with increasing size of flap above 11 repeats. In addition, FEN-1 processing of 5'-flap DNA depends on sequence, which play a role in the replication origin-dependent TNR instability. Interestingly, FEN-1 can cleave the 5'-flap DNA of CTG repeats better than CAG repeats possibly through the flap-structure. Our biochemical data of FEN-1's activity with triplet repeat DNA clearly shows length dependence, and aids our understanding on the mechanism of TNR instability.

Timed Analysis of Mouse 2 - Cell Embryo Development in Dulbecco's Modified Eagle Medium ( DMEM ) in The Presence of Glutamine With of Without Glucose / 대한산부인과학회잡지

OBJECTIVE: To evaluat the effects of a culture medium with glucose in the presence of glutamine on the development of mouse embryos. METHODS: Two-cell embryos recovered from ICR mice at 48 hrs after hCG injection (mated just after hCG injection) were cultured in DMEM (with 20% hFF) supplemented with or without glucose on the presence of glutamine. Embryos were cultured under three different glucose regimens: (1) 0 mM (control); (2) 0.5 mM (group I); or (3) 3.15 mM (group II), and were analyzed at 24, 48, 72 and 96 hours intervals. Chi-square test (x2-test) was used to compare values of groups. RESULTS: No differences were found in the number of embryos showing morula (control: 37.5%; group I: 51.0%; group II: 48.4%), blastocyst (control: 21.5%; group I: 33.3%; group II: 34.4%) and blastocyst and hatching or hatched blastocyst (control: 81.9%; group I: 83.3%; group II: 82.8%) between groups at 24 hrs, 48 hrs or 72 hrs respectively. However at 96 hrs, the number of hatched and attached blastocyst was significantly higher in group I (82.3%) and II (78.5%) than control (63.2%; P<0.05). CONCLUSION: The addition of glucose (0.5 mM) to the DMEM, as energy source, improved the rate of development of late stage embryos in mice.