This intervention study was performed to assess the effect of spirulina on lipid metabolism, antioxidant capacity, and immune function in elderly Koreans. The subjects were 6 male and 6 female people between the ages of 60 and 75, who were given spirulina supplements of 7.5 g/day for 24 weeks. Dietary intake, anthropometric measurements and biochemical assessment for plasma lipid levels, antioxidant status and immune function were measured before and throughout the intervention period. Before entering the study, the subjects were in relatively good health. Their nutrient intake was satisfactory, and anthropometric indices and plasma nutrient levels were within the normal range. Spirulina supplementation for 24 weeks did not affect dietary intake and anthropometric parameters. However, considerable changes were observed in blood lipid profiles, antioxidant capacity, and immune indices. The plasma concentrations of triglycerides, total- and LDL-cholesterol decreased from 4 weeks of the supplementation period. The antioxidant capacity improved, as shown in increasing TAS and decreasing TBARS after supplementation. Improved immune function was also observed as the PBL lymphocyte proliferation rate and plasma C3 levels increased. The above effects of spirulina supplementation did not differ between mild hypercholesterolemic (cholesterol > or =200mg/d1) and normochole-sterolemic (cholesterol <200 mg/dl) subjects. This study provided evidence that spirulina could be used as dietary supplementation in nutritionally vulnerable groups to improve nutritional and health status and to prevent chronic disease such as hyperlipidemia or oxidation-prone diseases. further studies in this area with various population groups are warranted.
Aged ; Chronic Disease ; Dietary Supplements ; Female ; Humans ; Hyperlipidemias ; Clinical Trial ; Lipid Metabolism* ; Lymphocytes ; Male ; Plasma ; Population Groups ; Reference Values ; Spirulina* ; Thiobarbituric Acid Reactive Substances ; Triglycerides

PURPOSE: The aim of this study is to evaluate the efficacy and feasibility of four-field box whole brain radiotherapy (FB-WBRT) with tilting baseplate by comparing bilateral WBRT (B-WBRT). METHODS AND MATERIALS: Between March 2016 and September 2018, 20 patients with brain metastases underwent WBRT using the four-field box technique. WBRT is performed with a dose of 30 Gy in 10 fractions daily. Two computed tomography simulations per person were performed. One was in the traditional supine position for B-WBRT and the other by applying the tilting acrylic supine baseplate to elevate the head by 40° for FB-WBRT. The B-WBRT used the field-in-field technique, which is the most commonly used method in our institution. The FB-WBRT comprised anterior, posterior, and bilateral beams. A wedge was applied in anterior and posterior fields to compensate for skull convexity. RESULTS: The average of Dmean of both parotid glands was 10.2 Gy (range, 3.8 to 17.8 Gy) in B-WBRT and 5.4 Gy (range, 2.0 to 11.7 Gy) in FB-WBRT (p < 0.05). Compared to B-WBRT, FB-WBRT reduced the mean dose of the right and left parotid glands from 10.1 Gy to 4.9 Gy and from 10.4 Gy to 5.8 Gy, respectively (p < 0.05). Further, V₅, V₁₀, V₁₅, V₂₀ for the parotid gland decreased significantly in FB-WBRT (p < 0.05). The Dmax and Dmean of lens decreased according to the dose-volume histogram. CONCLUSION: Compared to B-WBRT, FB-WBRT with a tilting baseplate is a simple and effective method that takes feature of noncoplanar beam to protect the parotid gland.
Brain ; Head ; Humans ; Methods ; Neoplasm Metastasis ; Parotid Gland ; Radiotherapy ; Skull ; Supine Position

BACKGROUND: The purpose of this study was to evaluate the efficacy and feasibility of non-coplanar whole brain radiotherapy (NC-WBRT) for parotid sparing. METHODS: Fifteen cases, previously treated with WBRT were selected. NC-WBRT plans were generated. The beam arrangement for the non-coplanar plans consisted of superior anterior, right, and left beams. After generation of the non-coplanar plans a field-in-field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC-WBRT plans were subsequently compared with the previously generated bilateral WBRT (B-WBRT) plans. A field-in-field technique was also used with the B-WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week. RESULTS: The mean dose to the parotid gland for the two different plans were 16.2 Gy with B-WBRT and 13.7 Gy with NC-WBRT (p < 0.05). In the NC-WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p < 0.05) than those of the B-WBRT plan. The Dmax of the lens was also lower by 10% with NC-WBRT. CONCLUSION The use of NC-WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose-volume parameters of the parotid gland.

BACKGROUND: The purpose of this study was to evaluate the efficacy and feasibility of non-coplanar whole brain radiotherapy (NC-WBRT) for parotid sparing.METHODS: Fifteen cases, previously treated with WBRT were selected. NC-WBRT plans were generated. The beam arrangement for the non-coplanar plans consisted of superior anterior, right, and left beams. After generation of the non-coplanar plans a field-in-field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC-WBRT plans were subsequently compared with the previously generated bilateral WBRT (B-WBRT) plans. A field-in-field technique was also used with the B-WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week.RESULTS: The mean dose to the parotid gland for the two different plans were 16.2 Gy with B-WBRT and 13.7 Gy with NC-WBRT (p < 0.05). In the NC-WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p < 0.05) than those of the B-WBRT plan. The Dmax of the lens was also lower by 10% with NC-WBRT.CONCLUSION: The use of NC-WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose-volume parameters of the parotid gland.
Brain ; Institutional Practice ; Methods ; Parotid Gland ; Radiotherapy ; Xerostomia

Some Bacillus species present in fermented foods are regarded as probiotics because of their ability to modulate the prevention of some intestinal infections and the modulation of the inflammatory immune response. We isolated bacteriocin-like substances producing Bacillus subtilis and B. lentus from Cheonggukjang, a traditional Korean fermented soybean paste having an inhibitory effect against Salmonella Typhimurium using a well diffusion inhibition assay and a broth co-culturing method. B. subtilis or B. letus was fed to Drosophila melanogaster alone as well as in combination with Salmonella Typhimurium and survival was monitored daily. The survival rates by oral feeding B. subtilis, B. lentus and Salmonella Typhimurium separately resulted in 85, 90 and 75%, respectively. In contrast, survival rates of co-feeding of B. lentus with Salmonella Typhimurium were increased from 75 to 90% during 7 days post-feeding as compared to Salmonella Typhimurium alone. However, B. subtilis in co-feeding with Salmonella Typhimurium significantly reduced D. melanogaster survival rate (85 to 70%). We found that the immune response to B. lentus and Salmonella Typhimurium is characterized synergistic activation of antimicrobial peptide gene expression by Imd pathway. In conclusion, the in vitro and natural-route infection of the D. melanogaster digestive system can result in the use of the probiotic B. lentus for effective treatment of Salmonella Typhimurium infection. We therefore propose the strain B. lentus as a suitable candidate probiotics for use in the prevention and treatment of the intestinal infections caused by Salmonella Typhimurium.
Bacillus ; Bacillus subtilis ; Diffusion ; Digestive System ; Drosophila ; Drosophila melanogaster ; Gene Expression ; Intestines ; Peptides ; Probiotics ; Salmonella ; Salmonella typhimurium ; Soybeans ; Sprains and Strains ; Survival Rate

PURPOSE: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. MATERIALS AND METHODS: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. RESULTS: The 1- and 3-year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. CONCLUSION: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.
Female ; Follow-Up Studies ; Head ; Head and Neck Neoplasms ; Humans ; Hypopharynx ; Hypothyroidism ; Incidence ; Larynx ; Male ; Mouth ; Multivariate Analysis ; Neck ; Neck Dissection ; Oropharynx ; Retrospective Studies ; Risk Factors ; Thyroid Gland

Purpose: The purpose of this study was to explore nurses’ experience of falls, and their perception of the status quo of inpatient fall interventions. Methods: The participants were 28 ward nurses in a university hospital, Seoul, Korea. Five focus group interviews and three individual interviews were conducted. The interviews were analyzed using thematic analysis. Results: The findings from this study suggest that nurses face limitations in providing conventional fall interventions due to patient disease related characteristics, situations in hospital, and medical devices used in the hospital settings. Although nurses adopted their own strategies to prevent falls effectively, they expressed the need for innovative approaches to overcome these limitations. Conclusion Systematic, technology-based approaches are needed to create a safer physical environment and to improve current nursing interventions to prevent falls.

Purpose: Endocrine therapy is the first-line treatment recommended for patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer without visceral crisis. However, this recommendation has not been followed clinically because of efficacy issues. In this study, the survival of patients with HR-positive/HER2-negative metastatic breast cancer was evaluated based on the following first-line treatment regimens: the combination of palbociclib plus letrozole, conventional endocrine therapy, or chemotherapy. Methods: Medical records were reviewed for this retrospective analysis. Patients with HR-positive/HER2-negative metastatic breast cancer were included. Progression-free survival (PFS) and overall survival (OS) were compared based on first-line treatment regimens. Results: A total of 184 patients were included in the analysis. The first-line treatments were palbociclib plus letrozole in 46 patients (25.0%), endocrine therapy in 40 patients (21.7%), and chemotherapy in 98 patients (53.3%). The PFS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=3.43, p<0.001) and chemotherapy (hazard ratio=2.88, p=0.001) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.430). The OS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=5.34, p=0.009) and chemotherapy (hazard ratio 4.23, p=0.043) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.451). Conclusion The combination regimen of palbociclib and letrozole could be recommended as the first-line treatment of choice in patients with HR-positive/HER2-negative metastatic breast cancer.

Purpose: Phosphorylated AKT1 (p-AKT1) at Ser473 is a functional isoform of AKT and a key component of the PI3K/mTOR/AKT pathway. This study aimed to evaluate the prognostic significance of p-AKT1 (Ser473) based on the molecular subtypes of breast cancer. Methods: To investigate the prognostic value of p-AKT1 (Ser473), we performed a retrospective chart review of patients with breast cancer. Data on p-AKT1 (Ser473) positivity, hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) expression status, and other clinicopathological factors were obtained. Furthermore, the therapeutic effect of blocking p-AKT1 (Ser473) in breast cancer cells was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, cell apoptosis assay, apoptosis protein array, and western blot analysis. Results: A total of 3,044 patients were evaluated, and the median follow-up time was 43 (range: 0–125) months. In patients with HR-positive and HER2-positive disease, the p-AKT1 (Ser473)-positive group had worse disease-free survival (DFS) than the p-AKT1 (Ser473)-negative group (hazard ratio, 1.9; 95% confidence interval, 1.1–3.5; p = 0.024). In the multivariate analysis, p-AKT1 (Ser473) remained a significantly worse prognostic factor in patients with HR-positive/HER2-positive breast cancer (p = 0.03). There was no difference in DFS according to p-AKT1 (Ser473) status among patients with other breast cancer subgroups.In vitro analysis showed that blocking p-AKT1 (Ser473) levels enhanced trastuzumab-induced cell death in HR-positive/HER2-positive and p-AKT1 (Ser473)-positive breast cancer cells. Conclusion p-AKT1 (Ser473) is a prognostic marker for poor outcomes in patients with HRpositive/HER2-positive breast cancer and may have a potential value as a therapeutic target.

Prune-belly syndrome is a rare compound fetal anomaly, characterized by absence or hypoplasia of abdominal wall musculature associated with urinary tract abnormalities and cryptorchidism. The prenatal ultrasound diagnosis was based on the findings of a lower abdominal cystic echo caused by abnormal dilatation of the bladder, upward compression of small intestines and decreased amniotic fluid volume. We experienced a case of Prune-belly syndrome diagnosed by ultrasound in a 12 weeks fetus following to IVF-ET pregnancy. Termination was performed at 12 weeks and autopsy confirmed the distended bladder, absence of abdominal muscles and urethra. So, we reported this case with a brief review of literature.
Abdominal Muscles ; Abdominal Wall ; Amniotic Fluid ; Autopsy ; Cryptorchidism ; Diagnosis ; Dilatation ; Female ; Fetus ; Intestine, Small ; Male ; Pregnancy ; Prenatal Diagnosis ; Prune Belly Syndrome* ; Ultrasonography* ; Urethra ; Urinary Bladder ; Urinary Tract