Search

Isolated colon injuries following blunt abdominal trauma have been reported at a rate of 0.1%-0.5%, with isolated sigmoid colon injuries involved in only 34.8% of single colon injuries. Surgical treatment options include recto-colonic anastomosis, resection with or without recto-colonic anastomosis, and colostomy. We report the case of a 39-year-old male patient diagnosed with isolated sigmoid colon rupture after a traffic accident, identified using contrast-enhanced abdominal computed tomography. The patient underwent emergency surgery, during which the Hartmann procedure was performed. This included excision of the sigmoid colon at both ends of the hiatus, creation of a proximal colostomy, closure of the distal end, and repair of the sigmoid disruption segment. Seven days after surgery, the patient's clinical symptoms were stable, and he was discharged., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

A dose calculation for a person who has been in contact with a patient undergoing Nuclear medicine procedures can be performed by using Merged Phantom Tool (MPT). In this study, we are upgrading the MPT to help users easily merge phantoms at any axis and with any angle using the "vector rotation" technique. The segmented structure information of the contact's phantom is also included in the calculation using the GEANT4 "parallel geometry" utility. The calculation is applied to a case of a male cancer patient lying on a bed who has used I-131, and a caregiver standing beside the patient. The equivalent dose to the thyroid of the caregiver is calculated at 0.3, 0.5, 0.8 and 1m away from the patient, as the caregiver is standing near the patient's abdomen, chest and neck area. The results show that the dose to the thyroid of the contact greatly depends on his standing position and that there are clear differences between the results calculated with the point source and those calculated with the patient source. In summary, using activity distributions in the patient's body as well as the right communication circumstance helps to calculate the optimal dose for people who have been in contact with patients.

Two new contact circumstances called 'stand-lie' and 'front-rear' are implemented to the merged phantom tool. To allow more flexibility for users when they calculate the dose for a volume of interest (VOI) with arbitrary geometry, an optional utility to convert segmented structure information from the CARIMAS software into parallel geometry of GEANT4 is provided. The effective dose for a person who has been in contact with a male patient being treated for thyroid cancer with 131I is calculated for four circumstances: opposite, side by side, stand-lie and front-rear. The biggest dose is the 'opposite' circumstance and the smallest one is the 'stand-lie' circumstance. Using the dose distribution in the patient's body and applying the right circumstance should be done to optimise the dose calculation for the contact person., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Early-onset Parkinson's disease (EOPD) refers to that of patients who have been diagnosed or had onset of motor symptoms before age 50, accounting for 4% of Parkinson's disease patients. The PRKN and PINK1 genes, both involved in a metabolic pathway, are associated with EOPD., Methods: To identify variants associated with EOPD, coding region of PARKIN and PINK1 genes in 112 patients and 112 healthy individuals were sequenced. Multiplex ligation-dependent probe amplification kit was used to determine EOPD patients that carried mutations in PRKN and PINK1 genes., Results and Conclusion: Three rare and three novel mutations in total of 14 variants of PARKIN and PINK1 were detected in the EOPD cohorts. Mutations of PRKN and PINK1 genes were found in five (4.4%) patients, which were four patients with compound heterozygous variants in the PRKN and one case with a homozygous mutation of the PINK1 gene. The novel mutations might reduce the stability of the PRKN and PINK1 protein molecules. The frequency of homozygous mutant genotype p.A340T of the PINK1 in the EOPD cohort was higher than in control (p = 0.0001, OR = 5.704), suggesting this variant might be a risk factor for EOPD. To the best of our knowledge, this is the first study of PRKN and PINK1 genes conducted on Vietnamese EOPD patients. These results might contribute to the genetic screening of EOPD in Vietnam., (© 2020 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC.)

Purpose: This report introduces a tool for merging two voxel phantoms to calculate the deposited dose that a person receives from a patient undergoing Nuclear medicine procedures., Materials and Methods: The phantoms must be converted to the text format used by GEANT4 to treat DICOM images via the GAMOS utilities. The Merge Phantoms Tool can merge two phantoms in two different cases: standing either side by side or opposite. The merged phantom is also in text format and is subsequently input back into GAMOS to calculate the equivalent dose that a person receives from a patient. The equivalent doses to the eyes of people in contact are calculated in a case where a patient was administered 185 MBq of 18F-FDG during a PET examination., Results: The corresponding doses when the two phantoms are standing opposite are greater than those when they are standing side by side and smaller than those from point and tube source calculated by Sumi Yokoyama at any distance., Conclusions: The Merge phantoms tool and GAMOS software can be used to calculate the deposited dose that a person receives from a patient. An accurate dose calculation can be used for radiation protection, or deciding whether a patient can be released from isolation if the dose is small even in a close contact., (Copyright © 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

Aim: The aim of this study is to verify the Prowess Panther jaws-only intensity modulated radiation therapy (JO-IMRT) treatment planning (TP) by comparing the TP dose distributions for head-and-neck (H&N) cancer with the ones simulated by Monte Carlo (MC)., Background: To date, dose distributions planned using JO-IMRT for H&N patients were found superior to the corresponding three-dimensional conformal radiotherapy (3D-CRT) plans. Dosimetry of the JO-IMRT plans were also experimentally verified using an ionization chamber, MapCHECK 2, and Octavius 4D and good agreements were shown., Materials and Methods: Dose distributions of 15 JO-IMRT plans of nasopharyngeal patients were recalculated using the EGSnrc Monte Carlo code. The clinical photon beams were simulated using the BEAMnrc. The absorbed dose to patients treated by fixed-field IMRT was computed using the DOSXYZnrc. The simulated dose distributions were then compared with the ones calculated by the Collapsed Cone Convolution (CCC) algorithm on the TPS, using the relative dose error comparison and the gamma index using global methods implemented in PTW-VeriSoft with 3%/3 mm, 2%/2 mm, 1%/1 mm criteria., Results: There is a good agreement between the MC and TPS dose. The average gamma passing rates were 93.3 ± 3.1%, 92.8 ± 3.2%, 92.4 ± 3.4% based on the 3%/3 mm, 2%/2 mm, 1%/1 mm criteria, respectively., Conclusions: According to the results, it is concluded that the CCC algorithm was adequate for most of the IMRT H&N cases where the target was not immediately adjacent to the critical structures.

Lead poisoning is a public health problem in many areas of the world. Children are at particularly high risk for adverse effects of lead exposure; even at low concentrations, lead can affect physical, mental, and behavioral development. Children living near lead-zinc mines are at high risk for environmental lead poisoning, especially the contaminated soil. We conducted a cross-sectional descriptive study in Ban Thi Commune, northern Vietnam. 195 children (92,9% participation) aged 3-14 years old (average: 7.69 ± 2.90) were randomly selected from a list of all children prepared by the village health collaborators. 109 (55.90%) were boys and 86 (44.10%) were girls. The research measures were the lead concentration in native soil and the children's total blood lead concentration determined by the inductively coupled plasma-mass spectrometry (ICP-MS) method. The results showed that lead content in soil was many times higher than American Environmental Protection Agency and Vietnam standards (average 2980.23 ± 6092.84 mg/kg dry weight of soil (range 80.05 - 33820.62)). Average blood lead levels for children were 15.42 ± 6.45  μ g/dL (95% CI: 14.50 -16.33  μ g/dL). The percentage of children with lead levels >10  μ g/dL (value considered to be lead poisoning for children according to the Ministry of Health of Vietnam) was 79.49% of the total number of children. None of the children in this study had blood lead level (BLL) that required chelation treatment according to Vietnam MOH guideline (BLL ≥45  μ g/dL). There is weakly evidence that lead exposure relates to the physical development of children. Children with low lead concentrations (less than 10  μ g/dL) had height and weight of 1.47-3.51 cm and 1.19-2.81 kg, greater than those with BLL >10  μ g/dL (p>0.05).

Intensity-modulated radiation therapy (IMRT) is a treatment technique which has become routine in developed countries. In most centers this technique is delivered with multi-leaf collimators (MLCs). However, the use of MLCs is not mandatory. Several oncology centres in developing countries are still using linear accelerators (LINAC) without MLCs, and can potentially deliver IMRT plans with the use of collimator jaws. In this report, we present the results of quality assurance of this Jaws-Only-IMRT (JO-IMRT) technique in treating nasopharyngeal carcinoma (NPC) patients. Twenty-five plans of nasopharyngeal patients were randomly chosen. For each patient, a JO-IMRT plan was generated and a series of pre-treatment verification measurements was performed including (1) point dose measurement with an ionization chamber, (2) planar dose measurement with a 2D-array detector and (3) 3-dimensional dose measurement using a rotatable phantom with a 2D-array detector. The average differences between the measured and TPS-calculated point doses were found to be 1.26±0.77%, which is within the institution's dose constraint limits. For the planar dose and 3D dose measurements, the average gamma index based on 3%/3mm criteria were 96.77±2.33% and 94.72±2.67%, respectively. Our measurements showed that the JO-IMRT treatment plans applied to the H&N patients were accurate for the treatment delivery based on our established pass criteria., (Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

Objectives: To identify demand for Vi typhoid fever vaccine for school-age children; obstacles and enabling factors for vaccine delivery; and socio-behavioural factors associated with trial participation and possible predictors of future vaccine acceptance, in Hue City, Viet Nam., Methods: Pre- and post-trial surveys of randomly selected households with children aged 6-17 years. Simple multinomial logistic analyses for ratios of relative risks (RRR) and significance on trial participation by demographics and variables related to typhoid fever, vaccination, and pre-trial experiences with information and consents. Multiple logistic regressions to assess differences in participation based on child's characteristics., Results: As many as 62.6% of households let all school age children participate, 10.2% let some participate, and 26.8% let none of their children participate in the trial. Factors associated with all children participating included past use of healthcare facilities (RRR, 0.45; 95% CI, 0.24-0.83), knowledge of vaccines (RRR, 0.17; 95% CI, 0.03-0.86), and perceived causes of typhoid fever (RRR, 0.90; 95% CI, 0.81-0.99). Factors associated with some children participating included utilization of healthcare facilities (RRR, 0.08; 95% CI, 0.01-0.66) and perceived severity of typhoid fever (RRR, 0.64; 95% CI 0.46-0.88). Participation was associated with satisfaction regarding pre-vaccination information and consent procedures. Children and adolescents were active decision-makers. Only 14 of 461 (2.2%) respondents would not use the Vi vaccine in the future for their child(ren)., Conclusions: Inter-related factors contribute to participation in a clinical vaccine trial, which may differ from desire to participate in a public health campaign. Educational campaigns need to be targeted to children and adolescents, and consideration for assent procedures for minors. Obtaining informed consent may affect trial participation within a social and political system unaccustomed to these procedures.

We assessed the long-term protection afforded by a killed whole-cell oral cholera vaccine produced in Vietnam. A mass immunization of children and adults with the killed whole-cell oral cholera vaccine was undertaken in half of the communes of Hue, Vietnam, in 1998; the remaining communes were immunized in 2000. No cholera was observed in Hue until 2003, when an outbreak of El Tor cholera made it possible to conduct a case-control study. The overall vaccine effectiveness 3-5 years after vaccination was 50% (9-63%). This low-cost, easily administered vaccine should be considered as a tool for the control of cholera.

We report the coverage, safety, and logistics of a school-based typhoid fever immunization campaign that took place in Hue City, central Vietnam; a typhoid fever endemic area. A cluster-randomized evaluation-blinded controlled trial was designed where 68 schools (cluster) were randomly allocated the single dose Vi polysaccharide vaccine (Typherix) or the active control hepatitis A vaccine (Havrix). A safety surveillance system was implemented. A total of 32,267 children were immunized with a coverage of 57.5%. Strong predictors for vaccination were attending primary schools, peri-urban location of the school, and low family income. Human resources were mainly schoolteachers and the campaign was completed in about 1 month. Most adverse events reported were mild. Safe injection and safe sharp-waste disposal practices were followed. A typhoid fever school-based immunization campaign was safe and logistically possible. Coverage was moderate and can be interpreted as the minimum that could have been achievable because individual written informed consent procedures were sought for the first time in Hue City and the trial nature of the campaign. The lessons learned, together with cost-effectiveness results to be obtained by the end of follow-up period, will hopefully accelerate the introduction of Vi typhoid fever vaccine in Vietnam.