Bone Regeneration ; Nanoparticles ; Osseointegration ; Osteogenesis ; Rabbits ; Silver ; Tibia ; Torque

BACKGROUND: Bile examination is believed to be the most precise method for detecting Clonorchis sinensis (CS) eggs. We carried out bile examination to evaluate infestation state of CS in patients with pancreatobiliary diseases in Ulsan, known as an endemic area of CS infestation. METHODS: We examined CS eggs in bile in three hundreds and nine patients with pancreatobiliary diseases. The bile was obtained from endoscopic nasobiliary or percutaneous transhepatic biliary drainage tubes. RESULTS: The overall egg positive rate was 27.5% (35.3% in male, 17.6% in female). The egg positive rate was not significantly different according to the age group: 20.0% in thirties, 26.7% in forties, 24.2% in fifties, 29.9% in sixties, 36.2% in seventies and 16.7% in eighties or more. The egg positive rate according to the disease, except CS cholangitis, was not also statistically different: 32.6% in bile duct cancer, 38.5% in gallbladder cancer, 11.1% in ampulla of Vater cancer, 24.0% in pancreatic cancer, 26.4% in gallstone diseases and 12.5% in the reminder. The location of gallstone and whether CS related diseases or CS unrelated diseases did not affect the egg positive rates. The egg positive rate in patients with normal radiological findings including cholangiography was 17.0%. CONCLUSION: This result shows that regardless of age, sex, and sorts of diseases, the infestation rate of CS was very high. On the basis of our results, it is therefore presumes that clonorchiasis is still endemic disease in Korea.
Ampulla of Vater ; Bile Duct Neoplasms ; Bile* ; Biliary Tract Diseases ; Cholangiography ; Cholangitis ; Clonorchiasis ; Clonorchis sinensis* ; Drainage ; Eggs ; Endemic Diseases ; Gallbladder Neoplasms ; Gallstones ; Humans ; Korea ; Male ; Ovum ; Pancreatic Diseases ; Pancreatic Neoplasms ; Ulsan*

BACKGROUND/AIMS: The diagnosis of clonorchiasis is based on demonstrating eggs in stool or bile. It is believed that bile examination is the most precise method for detecting eggs. We evaluated diagnostic usefulness of intradermal test (IDT) by comparing it with the result of bile examination. METHODS: For 88 patients with pancreatobiliary diseases, we examined Clonorchis sinensis eggs in bile and performed IDT for clonorchiasis. The bile was obtained from endoscopic nasobiliary or percutaneous transhepatic biliary drainage tubes. RESULTS: We calculated ROC curve to decide the cut-off value of IDT in determining diagnostic accuracy on the basis of bile examination. We chose a value of 40 mm2, which significantly improved the sensitivity, without reducing the specificity. With a cut-off value of 40 mm2, the sensitivity, specificity, positive and negative predictive values of IDT were 81.5%, 67.2%, 52.4%, and 89.1%, respectively. The value of IDT was not affected by age and showed no difference between benign and malignant diseases. However, in egg-positive patients, the mean value was lower in malignant diseases than in benign diseases. CONCLUSIONS: In patients with pancreatobiliary diseases, IDT with a cut-off value of 40 mm2 seems to be a valuable supplementary diagnostic test for clonorchiasis in view of its high sensitivity.
Aged ; Bile/parasitology ; Biliary Tract Diseases/*diagnosis ; Clonorchiasis/*diagnosis ; Female ; Humans ; *Intradermal Tests ; Male ; Middle Aged ; Pancreatic Diseases/*diagnosis ; Predictive Value of Tests ; Sensitivity and Specificity

The purpose of this study is to develop the optimization method for adjusting the film isocenter shift and to suggest the quantitative acceptable criteria for film dosimetry after optimization in the dynamic conformal arc radiation therapy (DCAR). The DCAR planning was performed in 7 patients with brain metastasis. Both absolute dosimetry with ion chamber and relative film dosimetry were performed throughout the DCAR using BrainLab's micro-multileaf collimator. An optimization method for obtaining the global minimum was used to adjust for the error in the film isocenter shift, which is the largest part of systemic errors. The mean of point dose difference between measured value using ion chamber and calculated value acquired from planning system was 0.51+/-0.43% and maximum was 1.14% with absolute dosimetry. These results were within the AAPM criteria of below 5%. The translation values of film isocenter shift with optimization were within +/-1 mm in all patients. The mean of average dose difference before and after optimization was 1.70+/-0.36% and 1.34+/-0.20%, respectively, and the mean ratios over 5% dose difference was 4.54+/-3.94% and 0.11+/-0.12%, respectively. After optimization, the dose differences decreased dramatically and a ratio over 5% dose difference and average dose difference was less than 2%. This optimization method is effective in adjusting the error of the film isocenter shift, which is the largest part of systemic errors, and the results of this research suggested the quantitative acceptable criteria could be accurate and useful in clinical application of dosimetric verification using film dosimetry as follows; film isocenter shift with optimization should be within +/-1 mm, and a ratio over 5% dose difference and average dose difference were less than 2%.
Brain ; Film Dosimetry ; Humans ; Neoplasm Metastasis ; Radiotherapy*