• Journal of Chest Surgery
• /
• v.37 no.8
• /
• pp.672-683
• /
• 2004

Background: The treatment results of the advanced lung carcinoma is not satisfactory with the present therapeutic modalities: surgical resection, anti-cancer chemotherapy, and radiotherapy or combination therapy. To predict the prognosis of the non-small-cell lung carcinoma, TNM classification has been was as the basic categorization; however, it has been not satisfactory. It is necessary to consider the causes and the prognosis of the lung carcinoma from another points of view rather the conventional methods. We intended to find out the relationship between the major apoptotic factor, p53 gene and the prognosis of the patient with lung carcinoma. Material and Method: Three hundreds and fifty-nine patients with lung carcinoma who underwent surgery were analysed. We observed p53 protein accumulated in the cellular nuclei. The p53 protein was detected by immuno-histo-chemical method. We collected information of the patient retrospectively. Result: p53 protein densities were observed in 40% in average as a whole. The protein density was 44 percent in man, 25 percent in woman, 49 percent in the squamous cell carcinoma, and 38 percent in the adenocarcinoma. There were significant correlations between the p53 protein density and the mortality in the squamous cell carcinoma (p=0.025), follow-up duration in TNM stage I group (p=0.010), and follow-up duration in the lobectomy patient group (p=0.043), and tumor cell differentiation (p=0.009). p53 protein densities were significantly different between the lobectomy and the pneumonectomy group (p=0.044). Conclusion: The authors found that p53 protein had some correlations with the prognosis of the lung cancer partially in some factors. We suggest the p53 protein density could be used as a marker of prognosis in the non-small-cell lung carcinoma.

• Radiation Oncology Journal
• /
• v.23 no.4
• /
• pp.230-235
• /
• 2005

Purpose: To evaluate the contralateral breast dose using a virtual wedge compared with that using a Physical wedge and an open beam in a Siemens linear accelerator. Materials and Methods: The contralateral breast dose was measured using diodes placed on a humanoid phantom. Diodes were placed at 5.5 cm (position 1), 9.5 cm (position 2), and 14 cm (position 3) along the medial-lateral line from the medial edge of the treatment field. A 6-MV photon beam was used with tangential irradiation technique at 50 and 230 degrees of gantry angle. Asymmetrically collimated $17{\times}10cm$ field was used. for the first set of experiment, four treatment set-ups were used, which were an open medial beam with a 30-degree wedged lateral beam (physical and virtual wedges, respectively) and a 15-degree wedged medial beam with a 15-degree wedged lateral beam (physical and virtual wedges, respectively). The second set of experiment consists of setting with medial beam without wedge, a 15-degree wedge, and a 50-degree wedge (physical and virtual wedges, respectively). Identical monitor units were delivered. Each set of experiment was repeated for three times. Results: In the first set of experiment, the contralateral breast dose was the highest at the position 1 and decreased in order of the position 2 and 3. The contralateral breast dose was reduced with open beam on the medial side ($2.70{\pm}1.46%$) compared to medial beam with a wedge (both physical and virtual) ($3.25{\pm}1.59%$). The differences were larger with a physical wedge ($0.99{\pm}0.18%$) than a virtual wedge ($0.10{\pm}0.01%$) at all positions. The use of a virtual wedge reduced the contralateral breast dose by 0.12% to 1.20% of the proscribed dose compared to a physical wedge with same technique. In the second experiment, the contralateral breast dose decreased in order of the open beam, the virtual wedge, and the physical wedge at the position 1, and it decreased in order of a physical wedge, an open beam, and a virtual wedge at the position 2 and 3. Conclusion: The virtual wedge equipped in a Siemens linear accelerator was found to be useful in reducing dose to the contralateral breast. Our additional finding was that the surface dose distribution from the Siemens accelerator was different from a Varian accelerator.

• Radiation Oncology Journal
• /
• v.20 no.4
• /
• pp.367-374
• /
• 2002

Purpose : To investigate the growth inhibitory effects, and the underlying mechanism of human colon cancer cell (HT-29) death, induced by a new synthetic bile acid derivative (HS-1200). Materials and Methods : Human colon cancer cells (HT-29), in exponential growth phase, were treated with various concentrations of a new synthetic bile acid derivative (HS-1200). The growth inhibitory effects on HT-29 cells were examined using a frypan blue exclusion assay. The extent of apoptosis was determined using agarose gel electrophoresis, TUNEL assays and Hoechst staining. The apoptotic cell death was also confirmed by Western blotting of PARP, caspase-3 and DNA fragmentation factor (DFF) analysis. To investigate the involvement of mitochondria, we employed immunofluorescent staining of cytochrome c and mitochondrial membrane potential analyses. Results : The dose required for the half maximal inhibition $(IC_{50})$ of the HT-29 cell growth was $100\~150\;{\mu}M$ of HS-1200. Several changes, associated with the apoptosis of the HT-29 cells, were reveal by the agarose gel eletrophoresis, TUNEL assays and Hoechst staining, following their treatment with $100\;{\mu}M$ of HS-1200. HS-1200 treatment also induced caspase-3, PARP and DFF degradations, and the western blotting showed the processed caspase-3 p20, PARP p85 and DFF p30 and p11 cleaved products. Mitochondrial events were also demonstrated. The cytochrome c staining indicated that cytochrome c had been released from the mitochondria in the HS-1200 treated cells. The mitochondrial membrane potential $(\Delta\Psi_m)$ was also prominently decreased in the HS-1200 treated cells. Conclusion : These findings suggest that the HS-1200 - induced apoptosis of human colon cancer cells (HT-29) is mediated via caspase and mitochondrial pathways.

• Radiation Oncology Journal
• /
• v.25 no.2
• /
• pp.125-133
• /
• 2007

[ $\underline{Purpose}$ ]: This study was to design and fabricate a phantom for prostate cancer brachytherapy to validate a developed program applying a 3-film technique, and to compare it with the conventional 2-film technique for determining the location of an implanted seed. $\underline{Materials\;and\;Methods}$: The images were obtained from overlapped seeds by randomly placing a maximum of 63 seeds in the anterior-posterior (AP) position and at $-30^{\circ} to $30^{\circ} at $15^{\circ} intervals. Images obtained by use of the phantom were applied to the image processing procedure, and were then processed into the development program for seed localization. In this study, cases were set where one seed overlapped, where two seeds overlapped and where none of the three views resolved all seeds. The distance between the centers of each seed to the reference seed was calculated in a prescribed region. This distance determined the location of each seed in a given band. The location of the overlapped seeds was compared with that of the 2-film technique. $\underline{Results}$: With this program, the detection rate was 92.2% (at ${\pm}15^{\circ}), 94.1% (at ${\pm}30^{\circ}) and 70.6% (compared to the use of the 2-film technique). The overlaps were caused by one or more than two seeds that overlapped; the developed program can identify the location of each seed perfectly. However, for the third case the program was not able to resolve the overlap of the seeds. $\underline{Conclusion}$: This program can be used to improve treatment outcome for the brachytherapy of prostate cancer by reducing the number of errors in the process of reconstructing the locations of perfectly overlapped seeds.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.337-344
• /
• 2000

Purpose :To design and test test CT simulator phantom for geometrical test. Materials and Methods : The PMMA phantom was designed as a cylinder which is 20 cm in diameter and 24 cm in length, along with a 25$\times25\times31cm^{3}$ rectangular parallelepiped. Radio-opaque wires of which diameter is 0.8 mm are attached on the other surface of the phantom as a spiral. The rectangular phantom was made of four 24$\times24\times0.5 cm^{3}$ square plates and each plate had a 24$\times24 cm^{2}$, 12$\times12cm^{2}$, 6$\times6 cm$^{2}$ square line. The squares were placed to face the cylinder at angles 0 $^{\circ}$ , 15 $^{\circ}$ , 30 $^{\circ}$ ,respectively. The rectangular phantom made it possible to measure the field size, couch angle, the collimator angle, the isocenter shift and the SSD, the measurements of the gantry angle from the cylindrical part. A virtual simulation software, AcOSim, offered various conditions to perform virtual simulations and these results were used to perform the geometrical Quality assurance of CT simulator. Results : A 0.3$\~$0.5 mm difference was found on the 24 cm field size which was created with the DRR measurements obtained by scanning of the rectangular phantom. The isocenter shift, the collimator rotation, the couch rotation, and the gantry rotation test showed 0.5$\~$1 mm, 0.5$\~$l$^{\circ}$ 0.5$\~$ 1$^{\circ}$ , and 0.5-1 $^{\circ}$ differences, respectively. We could not find any significant differences between the results from the two scanning methods. Conclusion :The geometrical test phantom developed in the study showed less than 1 mm (or 1 $^{\circ}$ ) differences. The phantom could be used as a routine geometrical QC/QA tools, since the differences are within clinically acceptable ranges.

• The Korean Journal of Nuclear Medicine
• /
• v.34 no.2
• /
• pp.119-128
• /
• 2000

Purpose: The aim of this study was to investigate the diagnostic role of $^{99m}Tc$-Tetrofosmin in detection of breast cancer and compared with that of $^{99m}Tc$-MIBI. Material and Methods: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. Results: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of $^{99m}Tc$-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of $^{99m}Tc$-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin acintimammographies and its size was 0.5 cm. Conclusion: $^{99m}Tc-Tetrofosmin\;and\;^{99m}Tc-MIBI$ were non-invasive and useful in detection of breast cancer and $^{99m}Tc$-Tetrofosmin was comparable to the $^{99m}Tc$-MIBI in detection of primary breast cancer.

• The Korean Journal of Nuclear Medicine
• /
• v.36 no.6
• /
• pp.344-356
• /
• 2002

Purpose: RBC blood pool SPECT has been used to diagnose focal liver lesion such as hemangioma owing to its high specificity. However, low spatial resolution is a major limitation of this modality. Recently, ordered subset expectation maximization (OSEM) has been introduced to obtain tomographic images for clinical application. We compared this new modified iterative reconstruction method, OSEM with conventional filtered back projection (FBP) in imaging of liver hemangioma. Materials and Methods: Sixty four projection data were acquired using dual head gamma camera in 28 lesions of 24 patients with cavernous hemangioma of liver and these raw data were transferred to LINUX based personal computer. After the replacement of header file as interfile, OSEM was performed under various conditions of subsets (1,2,4,8,16, and 32) and iteration numbers (1,2,4,8, and 16) to obtain the best setting for liver imaging. The best condition for imaging in our investigation was considered to be 4 iterations and 16 subsets. After then, all the images were processed by both FBP and OSEM. Three experts reviewed these images without any information. Results: According to blind review of 28 lesions, OSEM images revealed at least same or better image quality than those of FBP in nearly all cases. Although there showed no significant difference in detection of large lesions more than 3 cm, 5 lesions with 1.5 to 3 cm in diameter were detected by OSEM only. However, both techniques failed to depict 4 cases of small lesions less than 1.5 cm. Conclusion: OSEM revealed better contrast and define in depiction of liver hemangioma as well as higher sensitivity in detection of small lesions. Furthermore this reconstruction method dose not require high performance computer system or long reconstruction time, therefore OSEM is supposed to be good method that can be applied to RBC blood pool SPECT for the diagnosis of liver hemangioma.

• The Journal of Korean Medicine
• /
• v.44 no.1
• /
• pp.65-75
• /
• 2023

Objectives: Objectives: In this study, we define a medical service type that combines Western medicine, Korean medicine, and complementary and alternative medicine (CAM) as an integrated medical service. This study, as part of tertiary hospital-based integrated medical service model and clinical field application, aims to collect status and opinions on integrated medical service for medical staff in the field. Methods: This is a survey study, and was conducted on doctors from Kyung Hee University Hospital and Korean medicine doctors from Kyung Hee University Korean Medicine Hospital. Respondents were recruited on a first-come, first-served basis until the number of respondents reached 120. The investigation was conducted for a total of 16 days from October 4, 2021 to October 19, 2021 by e-mail. Results: Recognition of integrated medical services was confirmed to be 45.8%, and 49.2% responded positively to the necessity of it. As a group of diseases that require the establishment of integrated medical services in the future, 'disorders of musculoskeletal systems and connective tissues' was the highest. The most expected advantages of providing integrated medical services were 'increased satisfaction of patients and guardians' and 'increased treatment effects.' Conclusions: In this study, we investigated the perception of doctors and Korean medicine doctors on integrated medical services that combine Western medicine, Korean medicine, and CAM. It has been confirmed that medical staff generally have a positive perception of integrated medical services, and if the scientific basis for the effect of integrated medical services is supported, the rate of positive perception is expected to increase.

• Journal of Chest Surgery
• /
• v.36 no.3
• /
• pp.157-163
• /
• 2003

Traditionally, patients with stage IIIB non small cell lung cancer (NSCLC) have been con-sidered Inoperable due to the short-term survival rate of this disease. However, some recent papers have reported good surgical treatment results for T4 lesions in stage IIIB NSCLC. This study reports the results of stage IIIB NSCLC patients who underwent surgical treatment at our institute. Material and Method: This study includes 109 patients who were diagnosed with pathological stage IIIA lung cancer and 59 patients who were diagnosed with pathological stage IIIB at our institute between 1994 to December 2001. Patients who underwent neo-adjuvant chemotherapy and radiation therapy were excluded from this study. According to the TNM classification, 13 patients from stage IIIA were classified into T3N1, 12 into T1N2, 73 into T2N2 and 11 into T3N2. Stage IIIB patients consisted of 26 patients with T4N0, 18 with T4Nl, 14 with T4N2, and 1 with T4N3. Result: The 30-day mortality for stage IIIA and IIIB were 4.58% and 5.08% respectively. The overall survival rate at the 1st, 2nd, 3rd, and 5th year were 69.1%, 53.7%, 41.6%, and 30.7% respectively in stage IIIA and 68.8%, 55.6%, 42.9%, and 35.9% respectively in stage IIIB. Patients with satellite nodules in the same lobe & no Iymph node involvement had a survival rate of 53.9% in 3 years compared with 15.2% in patients with satellite nodules in the same lobe with Iymph node involvement. Conclusion: Surgical treatment is recommended for selected stage IIIB NSCLC patients (pathological N0 stage & completely resectable patients), particularly for patients with satellite nodules in the same lobe & no lymph node involvement.

• Korean Journal of Agricultural and Forest Meteorology
• /
• v.5 no.1
• /
• pp.11-17
• /
• 2003

pH value of sampled fogwater at source regions (above highway and road) in Yongin sites showed the lowest value and was increased after passing the forest stands. Changes of ion concentrations through the forest stands showed a lowering tendency at sampling sites. The fogwater passing the forest stands (Quercus mangolica and Pinus rigida) surrendered acid pollutants to crown and stem from the atmosphere. It was concluded that environmental moisture in the atmosphere is acidified in fogwater. The influence was extended to the pure zone, and the frequency of acid rain has increased. The forests are assumed to remove air pollutants because ion concentrations in fogwater decreased after passing the forests. The fogwater which functions as a local sink for pollutants (H$_2$SO$_4$, HNO$_3$, etc.) falling on plant surfaces is considered to effectively remove acid pollutants. But if the deposition of pollutants exceeds the capacity of purification, it would damage the forest ecosystem. Further investigation is necessary to identify tree species tolerant to acid pollutants.