Experimental measurements of dose characteristics with pentagonal applicator at nominal energy of 4, 6, 9, 12 and 15 MeV electron beam were performed for intraoperative radiotherapy (IORT) in ML-15MDX linear accelerator. This paper presents the percent depth dose, surface dose, beam flatness and output factors of using the IORT applicator in different electron beam energy. The output factor showed as a 24 percent higher in IORT applicator than that of reference 10x10 cm? applicator. The surface dose of using the IORT applicator showed 7.7 and 2.7 percent higher than that of reference field in 4 and 15 MeV electron beam, respectively. In our experiments, the variation of percent depth dose was very small but the output factor and flatness at 0.5 cm depth have showed a large value in IORT applicator.
Particle Accelerators ; Radiotherapy

BACKGROUND: Melanomas need to be differentiated from benign melanocytic lesions during diagnosis. However, it is difficult to differentiate them using histopathology alone, since both neoplasms have broad morphological spectrums and subtle differentiating features. OBJECTIVE: To evaluate the usefulness of Ki-67/Melan-A double staining for differentiating melanoma from benign melanocytic nevi. METHODS: We selected 20 cases of intradermal nevi, 20 cases of compound nevi, 5 cases of dysplastic nevi, and 25 cases of melanoma from clinicopathologically proven cases reviewed by the Department of Dermatology at our medical center. Ki-67/Melan-A double staining was performed, and the Melan-A verified Ki-67 index (Ki-67-M index) and Ki-67 index were measured. The immunopositivity was measured in the deepest third of the lesions. RESULTS: The Ki-67-M index of intradermal nevi, compound nevi, dysplastic nevi, and melanoma were 0.4+/-0.9%, 1.0+/-1.1%, 4.3+/-1.7%, and 24.1+/-10.9%, respectively. The best Ki-67/Melan-A cut-off point to distinguish melanomas from benign melanocytic nevi was 5%; the sensitivity and specificity were 100% and 97.7%, respectively. Immunopositivity in the deepest third of the intradermal nevi, compound nevi, and melanoma, were 10.5%, 20%, and 100%, respectively; the sensitivity and specificity for diagnosing melanoma were 100% and 84.6%, respectively. The sensitivity and specificity of combined Ki-67-M and immunopositivity in the deepest third for diagnosing melanoma were 100% and 97.7%, respectively. CONCLUSION: The Ki-67-M index and immunopositivity in the deepest third of melanoma were significantly higher than that of benign melanocytic nevi. Therefore, Ki-67/Melan-A double staining is a potentially valuable diagnostic tool for differentiating melanoma from benign melanocytic nevi.
Dermatology ; Diagnosis ; Dysplastic Nevus Syndrome ; MART-1 Antigen ; Melanoma* ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented* ; Sensitivity and Specificity

OBJECTIVES: The early detection of ectopic tubal pregnancy in unruptured state is increased as the transvaginal sonography and sensitive serum hCG test are available. For this unruptured tubal pregnancy, the medical treatment using methotrexate via various routes and dosage is being tried. Our study was to evaluate the efficacy of single systemic injection of methotrexate in the treatment of unruptured tubal pregnancies. Material and METHODS: From the January 1997 to July 1999, of 152 ectopic pregnancy patients, 22 patients who were diagnosed as unruptured tubal pregnancies were treated with single-dose systemic methotrexate injection (50 mg/m2/IM). Exclusion criteria were unstable vital signs with hemoperitoneum, adnexal mass > 5-6 cm. Serum hCG titers were checked before injection and 4, 7 day after injection. If serum hCG titer declined more than 15% on 7 day after injection compared with titer on 4 day, the weekly hCG titer was followed until it was <10 mIU/ml .If the hCG titer did not decline more than 15 %, a second dose was given. If hCG titer was not decreased or vital signs became unstable after 1-2 injections, the treatment was considered failure and surgery was done. RESULTS: 18 cases (82%) of 22 were successfully treated with single-dose methotrexate. The mean size of ectopic mass and initial serum hCG titers were 2.7+/-1.3 cm (range, 1.5-5.4 cm) and 3,298+/-1,007 mIU/ml (range, 132-12,239), respectively. Of 22, 6 cases (28%) needed second dose of methotrexate. The mean time to resolution of serum beta-hCG titer was 27.5+/-13.6 days (range, 8-53 days). Elevation of liver enzyme did not occurred in all cases during treatment. Initial hCG titer was more important prognostic factor than ectopic mass size for successful medical treatment. CONCLUSION: Single-dose methotrexate appears to be an effective medical treatment for the unruptured tubal pregnancy. However, patients selection using strict criteria is needed to increase its success rate.
Female ; Hemoperitoneum ; Humans ; Liver ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Vital Signs

PURPOSE: Although advancement in treatment and diagnostic tools related to hepatocelluar carcinoma has been much improved, long term survival rates of hepatocellular carcinoma are still low because of delayed clinical manifestations and underlying diseases causing the cancer. Various kinds of modalities to treat hepatocellular carcinoma have developed but surgical resection is still recognized as the best method. Therefore, we studied the associated factors of long-term survival after liver resection. METHODS: We retrospectively analyzed 184 patients who were pathologically diagnosed with hepatocellular carcinoma from May 1990 to December 2002. Associated factors of long-term survival classified as preoperative, operative, pathological and recurrence factors. Univariate and multivariate analyses were done using cross tabulation analysis and logistic regression analysis. RESULTS: The cumulative 1-, 3- and 5- year survival rates were 66%, 50% and 30%, respectively. Preoperative factors, significantly associated with long-term survival, were age of 60 years and under, tumor size, HBe Ag status and preoperative tumor marker level. As pathological factors, the vascular invasion and lymphatic invasion status were significantly associated. But cirrhosis of the liver was not associated with long-term survival. And in cases of recurrence, patients who had undergone repeat resection survived significantly longer. CONCLUSION: The most significant factors of multivariate analyses were lymphatic invasion status. Tumor size, ICG-R15 and HBe Ag status followed second. We should correct the preoperative factors through screening and early diagnosis. And when recurrence occurs, if the recurring cancer has resectability, repeat hepatectomy will increase the patient's lifespan.
Carcinoma, Hepatocellular ; Early Diagnosis ; Fibrosis ; Hepatectomy ; Humans ; Liver ; Logistic Models ; Mass Screening ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: This study was performed to evaluate the clinical usefulness of femoral double tunnel PCL reconstruction using the tibial inlay technique. MATERIALS AND METHODS: From January 2001 to August 2002, 21 patients underwent femoral double tunnel PCL reconstruction using the tibial inlay technique and were followed for more than 21 months. The mean age was 37 years old (range 16 to 60 years old). The clinical results were evaluated with the Lysholm score and the Tegner activity score. Radiologic analysis was performed using the posterior stress and Telos stress views. RESULTS: The average preoperative Lysholm and Tegner activity scores were 46.0 and 2.3, respectively, and improved to 94.5 and 5.3, respectively, at the final follow-up. The average preoperative scores of the combined posterolateral ligament injury group was 40.6 and 1.5, which improved to 77.1 and 3.5 at the final follow-up. Preoperatively, two cases were grade II, 13 cases were grade III, 6 cases were grade IV, and posterior translation was an average of 14.6 mm. Postoperatively, 18 cases were grade I, 3 cases were grade II, and posterior translation was an average 2.9 mm. In a push view using the Telos device (15 kg) at 30o and 90o of knee flexion, there were no differences in posterior translation. Complications were limitation of flexion (3 cases), limitation of extension (1 case) and quadriceps atrophy (mean, 2.6 cm). CONCLUSION: It is suggested that femoral double tunnel PCL reconstruction with the tibial inlay technique using anterolateral and posteromedial bundles is an effective technique for the restoration of knee function, stability, and activity. However long-term evaluation of patients and comparisons with femoral single tunnel reconstruction are required to confirm the effectiveness of this procedure.
Adult ; Atrophy ; Follow-Up Studies ; Humans ; Inlays* ; Knee ; Ligaments ; Posterior Cruciate Ligament*

This study investigated dexamethasone (DXM) residues in the milk from intramuscularly dosed dairy cows and established the withdrawal time (WT) of DXM in milk. Eighteen healthy Holstein cows were injected with 20 (DXM-1) or 40 mL (DXM-2) of a drug containing 1 mg/mL of DXM. After administering DXM, milk samples were collected from all cows at 12-hour intervals for five days. The DXM residue concentrations in milk were determined by liquid chromatography-mass spectrometry/mass spectrometry. The correlation coefficient of the calibration curve was 0.9966, and the limits of detection and quantification (LOQ) were 0.03 and 0.1 μg/kg, respectively. The recoveries were 97.0% to 104.0%, and the coefficient of variations was less than 7.22%. After treatment, DXM in DXM-1 was detected above the LOQ in two milk samples at 36 hours and below the LOQ in all milk samples of DXM-2 at 48 hours. Using the WT calculation program WT 1.4, the withdrawal periods of DXM-1 and DXM-2 in milk were established to be two days. In conclusion, the developed analytical method is sensitive and reliable for detecting DXM in milk. The estimated WT of DXM in bovine milk is shorter than the current milk WT recommendation of three days for DXM in lactating dairy cows.

This study was conducted to investigate tiamulin (TML) residues in the edible tissues of orally dosed broiler chickens and to re-establish the withdrawal time (WT). Thirty-six healthy Ross broiler chickens were administered 0.5 (TML-1) and 2.5 kg (TML-2) per ton feed, respectively, of the drug containing TML 78 g/kg for 10 days. Twenty-four tissue samples were collected from 6 chickens in each of the TML-1 and TML-2 groups on 0, 1, 3, and 5 days after drug administration, respectively. The residual concentrations of TML were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation coefficient of the calibration curves was 0.9978 to 0.9998, and the limits of detection and the limits of quantification (LOQ) were in the range of 0.03 to 0.06, and 0.1 to 0.2 µg/kg, respectively. Recoveries ranged between 89.0% to 116.7%, and the coefficients of variation were less than 13.9%. After the drug administration, TML in the TML-1 and TML-2 groups was detected above the LOQ in 1 and 6 samples of liver, respectively, at day 0, and in 1 liver sample from both groups on day one. At 3 days after administration, TML was detected below the LOQ in all samples of TML-1 and TML-2. The calculated WT of TML in both TML-1 and TML-2 using the WT calculation program WT 1.4 was 0 days. In conclusion, the developed analytical method is suitable for detection, and the calculated WT of TML in poultry edible tissues is shorter than the current recommended WT of 7 days for TML in broiler chickens.

Objective: Methamphetamine (MA), cocaine, and heroin cause severe public health problems as well as impairments in neural plasticity and cognitive function in the hippocampus. This study aimed to identify the genes differentially expressed in the hippocampi of cynomolgus monkeys in response to these drugs. Methods: After the monkeys were chronically exposed to MA, cocaine, and heroin, we performed large-scale gene expression profiling of the hippocampus using RNA-Seq technology and functional annotation of genes differentially expressed. Some genes selected from RNA-Seq analysis data were validated with reverse transcription-quantitative polymerase chain reaction (RT-qPCR). And the expression changes of ADAM10 protein were assessed using immunohistochemistry. Results: The changes in genes related to axonal guidance (PTPRP and KAL1), the cell cycle (TLK2), and the regulation of potassium ions (DPP10) in the drug-treated groups compared to the control group were confirmed using RT-qPCR. Comparative analysis of all groups showed that among genes related to synaptic long-term potentiation, CREBBP and GRIN3A were downregulated in both the MA- and heroin-treated groups compared to the control group. In particular, the mRNA and protein expression levels of ADAM10 were decreased in the MA-treated group but increased in the cocaine-treated group compared to the control group. Conclusion These results provide insights into the genes that are upregulated and downregulated in the hippocampus by the chronic administration of MA, cocaine, or heroin and basic information for developing novel drugs for the treatment of hippocampal impairments caused by drug abuse.

Objective: The aim of this study was to investigate differentially expressed genes and their functions in the hippocampus and striatum after heroin administration in cynomolgus macaques of different ages. Methods: Cynomolgus monkeys were divided by age as follows: 1 year (A1, n = 2); 3 to 4 years (A2, n = 2); 6 to 8 years (A3, n = 2); and older than 11 years (A4, n = 2). After heroin was injected intramuscularly into the monkeys (0.6 mg/kg), we performed large-scale transcriptome profiling in the hippocampus (H) and striatum (S) using RNA sequencing technology. Some genes were validated with real-time quantitative PCR. Results: In the hippocampus, the gene expression of A1H was similar to that of A4H, while the gene expression of A2H was similar to that of A3H. Genes associated with the mitogen-activated protein kinase signaling pathway (STMN1, FGF14, and MAPT) and -aminobutyric acid-ergic synapses (GABBR2 and GAD1) were differentially expressed among control and heroin-treated animals. Differential gene expression between A1S and A4S was the least significant, while differential gene expression between A3S and A2S was the most significant. Genes associated with the neurotrophin signaling pathway (NTRK1 and NGFR), autophagy (ATG5), and dopaminergic synapses (AKT1) in the striatum were differentially expressed among control and heroin-treated animals. Conclusion These results suggest that even a single heroin exposure can cause differential gene expression in the hippocampus and striatum of nonhuman primates at different ages.

Background: Ischemic stroke is a serious neurological disorder caused by blockages in cerebral artery. Protein phosphatase 2A (PP2A) is a phosphatase that performs a critical role in cell signaling and growth. PP2A subunit B acts as a neuroprotective agent in the nerve system. Chlorogenic acid, which is mainly found in roasted coffee, has antioxi‑ dant, anti-inflammatory, and anti-apoptotic effects. We hypothesized that chlorogenic acid modulates PP2A subunit B expression in ischemic stroke models and glutamate-mediated neurons. Middle artery occlusion (MCAO) surgery was operated and chlorogenic acid (30 mg/kg) or phosphate buffer saline was treated 2 h after MCAO. The cerebral cortex was collected 24 h after surgery and the change of PP2A subunit B expression was analyzed. Glutamate and/ or chlorogenic acid were treated in cultured neurons, further study was performed. Results: A decrease in PP2A subunit B expression in MCAO animals was identified. Chlorogenic acid alleviated this decrease due to ischemic injury. Moreover, the number of PP2A subunit B-positive cells in the ischemic cerebral cortex was significantly decreased, chlorogenic acid alleviated this decrease. We also found protective effects of chlo‑ rogenic acid in neurons exposed to glutamate. Glutamate decreased the expression of PP2A subunit B and chloro‑ genic acid mitigated this decrease. Our results elucidated that chlorogenic acid performs neuroprotective functions and attenuates the reduction of PP2A subunit B by brain damage and glutamate-mediated excitotoxicity. Conclusions We showed that chlorogenic acid attenuated the decrease of PP2A subunit B in ischemic injury and neurons exposed to glutamate. Since PP2A subunit B contributes to the protection of brain tissue, we can sug‑ gest that chlorogenic acid preserves neurons by modulating PP2A subunit B during ischemic damage.