• Journal of the Korean Society of Radiology
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• v.79 no.5
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• pp.271-275
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• 2018

The falciform ligament is a hepatic suspensory ligament that extends from the umbilicus to the diaphragm, containing the ligamentum teres and a vestigial remnant of the umbilical vein. Among the rarely-occurring pathologies of the falciform ligament, which include ligament cyst, tumor, abnormal vascularization, and congenital ligament defect, a falciform ligament abscess is even more sporadic. Accordingly, the definitive diagnosis of the falciform ligament abscess is rather challenging and may easily be misinterpreted as an infected choledochal cyst or a liver abscess. We present a 25-day-old infant with the falciform ligament abscess, which developed after the umbilical venous catheter insertion and was successfully treated with percutaneous drainage and antibiotic administration.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1312-1326
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• 2022

Purpose To investigate the added value of right down decubitus (RDD) CT when determining adjacent organ invasion in cases of advanced gastric cancer (AGC). Materials and Methods A total of 728 patients with pathologically confirmed T4a (pT4a), surgically confirmed T4b (sT4b), or pathologically confirmed T4b (pT4b) AGCs who underwent dedicated stomach-protocol CT, including imaging of the left posterior oblique (LPO) and RDD positions, were included in this study. Two radiologists scored the T stage of AGCs using a 5-point scale on LPO CT with and without RDD CT at 2-week intervals and recorded the presence of "sliding sign" in the tumors and adjacent organs and compared its incidence of appearance. Results A total of 564 patients (77.4%) were diagnosed with pT4a, whereas 65 (8.9%) and 99 (13.6%) patients were diagnosed with pT4b and sT4b, respectively. When RDD CT was performed additionally, both reviewers deemed that the area under the curve (AUC) for differentiating T4b from T4a increased (p < 0.001). According to both reviewers, the AUC for differentiating T4b with pancreatic invasion from T4a increased in the subgroup analysis (p < 0.050). Interobserver agreement improved from fair to moderate (weighted kappa value, 0.296-0.444). Conclusion RDD CT provides additional value compared to LPO CT images alone for determining adjacent organ invasion in patients with AGC due to their increased AUC values and improved interobserver agreement.

• Radiation Oncology Journal
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• v.22 no.1
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• pp.64-68
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• 2004

Purpose : To study the feasibility of verifying real-time 2-D dose distribution measurement system with the scintillation screen for the quality assurance. Materials and Methods : The water phantom consisted of a scintillation screen (LANEX fast screen, Kodak, USA) that was axially located in the middle of an acrylic cylinder with a diameter of 25 cm. The charge-coupled device (CCD) camera was attached to the phantom In order to capture the visible light from the scintillation screen. To observe the dose distribution In real time, the intensity of the light from the scintillator was converted to a dosage. The isodose contours of the calculations from RTP and those of the measurements using the scintillation screen were compared for the arc therapy and the Intensity modulated radiation therapy (IMRT). Results : The kernel, expressed as a multiplication of two error functions, was obtained in order to correct the sensitivity of the CCD of the camera and the scintillation screen. When comparing the calculated isodose and measured isodose, a discrepancy of less than 8 mm in the high dose region was observed. Conclusion : Using the 2-D dosimetry system, the relationship between the light and the dosage could be found, and real-time verification of the dose distribution was feasible.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.44-49
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• 2005

Although thymomas are relatively common mediastinal tumors, to date not only has a universal system of pathologic classification not been established but neither has a clearly defined predictable relationship between treatment and prognosis been made. Recently, a new guideline for classification was reported by WHO, and efforts, based on this work, have been made to better define the relationship between treatment and pro­gnostic outcome. In the present study a comparative analysis between the WHO classification and Masaoka stage system with the clinical disease pattern was conducted. Material and Method: A total of 98 patients undergoing complete resection for mediastinal thymoma between Juanuary 1993 and June 2003 were included in the present study. The male female ratio was 48 : 50 and the mean age at operation was $49.6{\pm}13.9\;years.$ A retrospective analytic comparison studying the relationship between the WHO classification and the Masaoka stage system with the clinical disease pattern of thymoma was conducted. Pathologic slide specimens were carefully examined, details of postoperative treatment were documented, and a relationship with the prognostic outcome and recurrence was studied. Result: There were 7 patients in type A according to the WHO system of classification, 14 in AB, 28 in B 1, 23 in B2, 18 in B3, and 9 in type C. The study of the relationship between the Masaoka stage and WHO classification system showed 4 patients to be in WHO system type A, 7 in type AB, 22 in B 1, 17 in B2, and 3 in type B3 among 53 $(54{\%})$ patients shown to be in Masaoka stage I. Among 28 $(28.5{\%})$ patients in Masaoka stage II system, there were 2 patients in type A, 7 in AB, 4 in B 1, 2 in B2, 8 in B3, and 5 in type C. Among 15 $(15.3{\%})$ in Masaoka stage III, there were 1 patient in type B1, 3 in B2, 7 in B3, and 4 in type C. Finally, among 2 $(2{\%})$ patients found to be in Masaoka stage IV there was 1 patient in type B1, and 1 in type B2. The mean follow up duration was $28{\pm}6.8$ months. There were 3 deaths in the entire series of which 2 were in type B2 (Masaoka stages III and IV), and 1 was in type C (Masaoka stage II). Of the patients that experienced relapse, 6 patients remain alive of which 2 were in type B2 (Masaoka III), 2 in type B3 (Masaoka I and III) and 2 in type C (Masaoka stage II). The 5 year survival rate by the Kaplan-Meier method was $90{\%}$ for those in type B2 WHO classification system, $87.5{\%}$ for type C. The 5 year freedom from recurrence rate was $80.7{\%}$ for those in WHO type B2, $81.6{\%}$ for those in type B3, and $50{\%}$ for those in type C. By the Log-Rank method, a statistically significant correlation between survival and recurrence was found with the WHO system of classification (p<0.05). An analysis of the relationship between the WHO classification and Masaoka stage system using the Spearman correction method, showed a slope=0.401 (p=0.023), showing a close correlation. Conclusion: As type C of the WHO classification system is associated with a high postoperative mortality and recurrence rate, aggressive treatment postoperatively and meticulous follow up are warranted. The WHO classification and Masaoka stage system were found to have a close relationship with each other and either the WHO classification method or the Masaoka stage system may be used as a predict prognostic outcome of Thymoma.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.291-301
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• 1998

Purpose : A retrospective study was conducted comparing single daily fraction (SDF) thoracic radiotherapy (TRT) with twice daily (BID) TRT to determine the potential benefit of BID TRT in limited-stage small cell lung cancer (SCLC). Endpoints of the study were response. survival, pattern of failure, and acute toxicity. Materials and Methods : Between November 1989 to December 1996, 78 patients with histologically proven limited-stage SCLC were treated at the Department of Therapeutic Radiology, Chungnam National University Hospital. Of these, 9 were irradiated for palliative intent, and 1 had recurrent disease. Remaining 68 patients were enrolled in this study. There were 26 patients with a median age of 58 years, and 22 (85$\%$) ECOG performance score of less than 1 in SDF TRT. There were 42 patients with a median age of 57 years, and 36 (86$\%$) ECOG performance score of less than 1 in BID TRT By radiation fractionation regimen, there were 26 in SDF TRT and 42 in BID TRT. SDF TRT consisted of 180 cGy, 5 days a week. BID TRT consisted of 150 cGy BID, 5 days a week in 13 of 42 and 120 cGy BID, in 29 of 42. And the twice daily fractions were separated by at least 4 hours. Total radiotherapy doses were between 5040 and 6940 cGy (median, 5040 cGy) in SDF TRT and was between 4320 and 5100 cGy (median, 4560 cGy) in BID TRT. Prophylactic cranial irradiation (PCI) was recommended for patients who achieved a CR. The recommended PCI dose was 2500 cGy/10 fractions. Chemotherapy consisted of CAV (cytoxan 1000 mg/$m^2$, adriamycin 40 mg/$m^2$, vincristine 1 mg/$m^2$) alternating with VPP (cisplatin 60 mg/$m^2$, etoposide 100 mg/$m^2$) every 3 weeks in 25 (96$\%$) of SDF TRT and in 40 (95$\%$) of BID TRT. Median cycle of chemotherapy was six in both group. Timing for chemotherapy was sequential in 23 of SDF TRT and in 3 BID TRT, and concurrent in 3 of SDF TRT and in 39 of BID TRT Follow-up ranged from 2 to 99 months (median, 14 months) in both groups. Results : Of the 26 SDF TRT, 9 (35$\%$) achieved a complete response (CR) and 14 (54$\%$) experienced a partial response (PR). Of the 42 BID TRT, 18 (43$\%$) achieved a CR and 23 (55$\%$) experienced a PR. There was no significant response difference between the two arms (p=0.119). Overall median and 2-year survival were 15 months and 26.8$\%$, respectively. The 2-year survivals were 26.9$\%$ and 28$\%$ in both arm, respectively (p=0.51). The 2-rear survivals were 35$\%$ in CR and 24.2$\%$ in PR, respectively. The grade 2 to 3 esophageal toxicities and grade 2 to 4 neutropenias were more common in BID TRT (p=0.028 0.003). There was no difference in locoregional and distant metastasis between the two arms (p=0 125 and 0.335, respectively). The most common site of distant metastasis was the brain. Conclusion : The median survival and 2-year survival were 17 months and 20.9$\%$ in SDF TRT with sequential chemotherapy, and 15 months and 28$\%$ in BID TRT with concurrent chemotherapy, respectively. We did not observe a substantial improvement of long-term survival in the BID TRT with concurrent chemotherapy compared with standard schedules of SDF TRT with sequential chemotherapy. The grade 2 to 3 esophageal toxicities and glade 2 to 4 neutropenias were more common in BID TRT with concurrent chemotherapy. Although the acute toxicities were more common in BID TRT with concurrent chemotherapy than SDF TRT with sequential chemotherapy, a concurrent chemotherapy and twice daily TRT was feasible. However further patient accrual and long-term follow up are needed to determine the potential benefits of BID TRT in limited-stage SCLC.

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.71-80
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• 1998

This study examines the levels of carbohydrate antigen 19-9(CA19-9) and cancer antigen 125(CA125) in serum and its related factors in healthy Korean population. Although CA19-9 and CA125 have been widely used tumor markers for gastroenteric cancers and ovarian cancer in Western countries, there are no information available on the serum levels of CA19-9 and CA125 in healthy population and the factors affecting the levels of these tumor markers in Korea. A cross-sectional study was performed to measure CA19-9 and CA125 among 76 healthy males and 95 healthy females in Korea. CA19-9 and CA125 were quantitated using solid-phase radioimmunoassay kits. Informations on the factors which might be related to the levels of these markers were collected by questionnaire(e.g., smoking, alcohol consumption, menstruation, oral pill use, breast-feeding history, etc.). There was no statistically significant difference in the mean of CA19-9 concentration between men(10.4 u/ml) and women(10.1 u/ml), whereas the mean of CA125 levels(11.2 u/ml) was higher in women than that(2.5 u/ml) in men. Although there was a statistically significant association between CA19-9 and average number of cigarette consumed per day(r=0.59, p=0.026) and total number of cigarettes consumed in women(r=0.74, p=0.003), the significance disappeared by multiple regression analysis after adjusting age and body mass index. Later age of menopause(p=0.035) and longer duration of breast-feeding(p=0.050) were significant predictors for CA125 levels in women by multiple regression analysis after adjusting age and body mass index. In conclusion, CA19-9 can be used as a stable tumor marker in clinical practices, however, menstruation and breast-feeding should be considered when CA125 is used in women.

• Radiation Oncology Journal
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• v.27 no.4
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• pp.201-209
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• 2009

Purpose: To investigate the care patterns for radiation therapy and to determine inter-hospital differences for patients with laryngeal carcinoma in Korea. Materials and Methods: A total of 237 cases of laryngeal carcinoma (glottis, 144; supraglottis, 93) assembled from 23 hospitals, who underwent irradiation in the year of 1998 and 1999, were retrospectively analyzed to investigate inter-hospital differences with respect to radiotherapy treatment. We grouped the 23 hospitals based on the number of new patients annually irradiated in 1998; and designated them as group A (${\geq}$900 patients), group B (${\geq}$400 patients and <900 patients), and group C (<400 patients). Results: The median age of the 237 patients was 62 years (range, 25 to 88 years), of which 216 were male and 21 were female. The clinical stages were distributed as follows: for glottis cancer, I; 61.8%, II; 21.5%, III; 4.2%, IVa; 11.1%, IVb; 1.4%, and in supraglottic cancer, I; 4.3%, II; 19.4%, III; 28.0%, IVa; 43.0%, IVb; 5.4%, respectively. Some differences were observed among the 3 groups with respect to the dose calculation method, radiation energy, field arrangement, and use of an immobilization device. No significant difference among 3 hospital groups was observed with respect to treatment modality, irradiation volume, and median total dose delivered to the primary site. Conclusion: This study revealed that radiotherapy process and patterns of care are relatively uniform in laryngeal cancer patients in Korean hospitals, and we hope this nationwide data can be used as a basis for the standardization of radiotherapy for the treatment of laryngeal cancer.

• Journal of Hospice and Palliative Care
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• v.4 no.1
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• pp.14-25
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• 2001

Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

• The Korean Journal of Nuclear Medicine
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• v.4 no.1
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• pp.1-9
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• 1970

철대사(鐵代謝)에 관(關)한 연구(硏究)는 과거(過去) 30년(年)동안 새로운 검사방법(檢査方法)의 도입(導入)으로 눈부신 발전(發展)을이룩하였다. 1937년(年) Heilmeyer 등(等)에 의(依)하여 Ortho-phenanthrolin방법(方法)의 개발(開發)로 저색소성빈혈(低色素性貧血)의 원인(原因)이 구명(究明)되고 또한 이에 대(對)한 치료(治療)의 원칙(原則)이 세워졌다. 그 후 심(甚)한 감염(感染)이나 악성종양(惡性腫瘍)을 가진 환자(患者)者에서 관찰(觀察)되는 빈혈(貧血)에 대(對)해서 하나의 가설(假說)을 세워 이를 설명(說明)하려 하였는데 이는 곧 혈장(血漿)으로부터 철분(鐵分)이 신속(迅速)히 소실(消失)되어 망내계(網內系)나 병변(病變)이 있는 국소부위(局所部位)에 주(主)로 모여 들어 특수(特殊)한 방어기능(防禦機能)을 발휘(發揮)한다는것으로 연자(演者)는 방사성동위원소(放射性同位元素)를 이용(利用)하여 이 가설(假說)을 증명(證明)하였으며 이 연구(硏究)에는 또한 이문호교수(李文鎬敎授)가 Freiburg대학(大學) 유학중(留學中) 참여(參與)한 바 있다. 철대사(鐵代謝)를 파악(把握)하기 위(爲)해서 $^{59}Fe$가 흔히 사용(使用)되는데 이러한 방사성동위원소(放射性同位元素)를 이용(利用)함으로서 다음 사항(事項)들을 관찰(觀察)할 수 있었다. 즉(卽) 1. 소화장기(消化臟器)로 부터의 철흡수(鐵吸收) 2. 혈장(血漿)에서의 철(鐵)의 소실속도(消失速度) 3. 혈장내(血漿內)에서의 철교체율(鐵交替率) 4. 적혈구(赤血球)의 철이용(鐵利用) 5. 생체내(生體內)의 철분포(鐵分布) 6. 철배설(鐵排泄)의 정량적(定量的) 분석(分析) 또한 근년(近年)에는 특수(特殊)한 기능(機能)을 발휘(發揮)할 수 있는 동위원소(同位元素)를 이용(利用)하여 철흡수(鐵吸收) 및 대사이외(代謝以外)에도 적혈구(赤血球)의 수명(壽命)과 혈액량등(血液量等)을 측정(測定)하게 되었다. 경구적(經口的)으로 투여(投與)된 철(鐵)은 대부분(大部分) 십이지장(十二指腸)의 상부(上部)에서 흡수(吸收)되고 무기철(無機鐵)이 보다 쉽게 흡수(吸收)되어 가(價)의 상태(狀態)로 된다. 혈장(血漿)에서는 transferrin에 의(依)해서 철(鐵)이 운반(運搬)된다. 혈장철(血漿鐵)의 대부분(大部分)은 혈색소분해(血色素分解)에서 유래(由來)되며 이는 다시 혈색소(血色素)의 재생(再生)에 이용(利用)되는데 혈장내(血漿內) 철교체율(鐵交替率)은 방사성철(放射性鐵)을 이용(利用)하여 측정(測定)할수 있다 이와같이 방사성철(放射性鐵)을 이용(利用)하여 철대사과정(鐵代謝過程)을 숙지(熟知)함으르서 임상(臨床)에 응용(應用)하기에 이르렀으며 다음과 같은 질환(疾患)의 진단(診斷)에 특(特)히 큰 도움을 준다. A. 진성철결핍증(眞性鐵缺乏症) : 혁색소철(血色素鐵) 및 저장철(貯藏鐵)을 포함(包含)한 생체내(生體內) 전철분(全鐵分)의 부족(不足)된 상태(狀態)로서 실혈(朱血)에 의(依)한 것이 대부분(大部分)이다. 이 경우 철흡수(鐵吸收)는 증가(增加), 혈장철치(血漿鐵値)는 저하(低下), 철소실속도(鐵消失速度)는 증가(增加)되며 혈장철(血漿鐵) 교체율(交替率)은 항진(亢進) 혹(或)은 정상(正常)이다. B. 심(甚)한 염증성(炎症性) 질환(疾患) : 이 경우에도 혈장철치(血漿鐵値)의 저하(低下), 소실속도(消失速度)의 증가(增加), 교체율(交替率)은 정상(正常)보다 4배(倍)까지 증가(增加)할 수 있다. 골수(骨髓)에서 보다는 간(肝), 비(脾)와 같은 망내계(網內系)에 방사성철(放射性鐵)이 집결(集結)되는 것으로 보아 혈색소철(血色素鐵)보다는 저장철(貯藏鐵)이 관여(關與)되는 것이다. C. 원발성(原發性) 혈색소증(血色素症)(Idiopathic hemochromatosis) : 혈장철(血漿鐵)의 증가(增加)가 현저(顯著)하며 transferrin 농도(濃度)는 정상(正常)보다 낮으나 거의 대부분(大部分)의 철분(鐵分)으로 포화(飽和)된다. 철흡수(鐵吸收)는 증가(增加)되고 철소실속도(鐵消失速度)는 감소(減少) 되어 있으나 교체율(交替率)은 항진(亢進)되어 있다. 혈장철(血漿鐵)은 간(肝), 비(脾) 등(等)의 기관(器管)으로 저장집결(貯藏集結)되어 철저류(鐵貯溜)가 증대(增大)되므로 철이용증((鐵利用症)은 저하(低下)된다. D. 선천성(先天性) 무(無)$\ulcorner$트란스헤 린$\lrcorner$증(症)(Congenital atransferrinemia) : 방사성철(放射性鐵)을 이용(利用)한 진단방법(診斷方法)으로 Freiburg에서 7세(歲)의 소녀(少女)에서 발견(發見)한 증례(症例)인데 간(肝), 비(脾), 심(心)의 비대(肥大)가 임상적(臨床的)으로 인지(認知)되었고 중증(重症)의 철결핍상(鐵缺乏狀)을 검출(檢出)할 수 있었다. 철흡수율(鐵吸收率)의 상승(上昇), 혈장철치(血裝鐵値)의 감소(減少), 혈장철소실속도(血漿鐵消失速度)의 증가(增加), 혈장철교체율(血漿鐵交替率)의 상승(上昇) 및 적혈구(赤血球)에서의 철분이용율(鐵分利用率)의 저하(低下)를 ferrokinetic study에서 알 수 있었고 간(肝)에서 고도(高度)의 방사능(放射能)이 검출(檢出)되는 반면(反面), 비(脾)에서는 극소(極小), 골수(骨髓)에는 전(全)혀 방사능(放射能)이 들어가 있지 않았다. 이 증례(症例)와 같이 transferrin이 없으면 철분(鐵分)은 쉽게 조직(組織)으로 들어가 hemosiderin으로 저장(貯藏)되고 골수(骨髓)는 고도(高度)의 철결핍증(鐵缺乏症)을 나타내어 기관철침착증(器管鐵沈着症)과 철결핍성빈혈(鐵缺乏性貧血)이 동시(同時)에 나타나게 된다. 철대사장애면(鐵代謝障碍面)으로 보아 많은 미해결점(未解決點)이 남아 있으며 앞으로 자라나는 젊은 학도(學徒)들이 구명(究明)할 문제(間題)라고 믿는다.

• Journal of the Institute of Electronics Engineers of Korea SD
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• v.44 no.8
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• pp.52-59
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• 2007

In this paper, we analyzed and measured implant isolation characteristics for a 1.25 Gbps monolithic integrated hi-directional (M-BiDi) optoelectronic system-on-a-chip, which is a key component to constitute gigabit passive optical networks (PONs) for a fiber-to-the-home (FTTH). Also, we derived an equivalent circuit of the implant structure under various DC bias conditions. The 1.25 Gbps M-BiDi transmit-receive SoC consists of a laser diode with a monitor photodiode as a transmitter and a digital photodiode as a digital data receiver on the same InP wafer According to IEEE 802.3ah and ITU-T G.983.3 standards, a receiver sensitivity of the digital receiver has to satisfy under -24 dBm @ BER=10-12. Therefore, the electrical crosstalk levels have to maintain less than -86 dB from DC to 3 GHz. From analysed and measured results of the implant structure, the M-BiDi SoC with the implant area of 20 mm width and more than 200 mm distance between the laser diode and monitor photodiode, and between the monitor photodiode and digital photodiode, satisfies the electrical crosstalk level. These implant characteristics can be used for the design and fabrication of an optoelectronic SoC design, and expended to a mixed-mode SoC field.