• Title/Summary/Keyword: 방법론 평가

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Alteration of Growth Factor Expression after Acute Ischemic Renal Injury (급성 허혈성 신손상 후 여러 성장인자 발현의 변화)

  • Koe, Yang Sim;Lee, Soo Yeon;Kim, Won;Cho, Soo Chul;Hwang, Pyoung Han;Kim, Jung Soo;Lee, Dae-Yeol
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.687-694
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    • 2003
  • Purpose : Regeneration and repair after ischemic renal injury appears to be modulated by circulating or locally produced growth factors. This study examined the changes of serum insulin like growth factor(IGF-I) and renal expression of IGF-I and II, vascular endothelial growth factor(VEGF), transforming growth $factor-{\beta}$($TGF-{\beta}$), and connective tissue growth factor(CTGF) during the active regeneration period after acute ischemic injury. Methods : Sera and kidney tissue samples(whole kidney, cortex, outer medullae and inner medullae) were obtained before and after one, three, five and seven days of 40 minutes bilateral renal pedicle clamping. Acute renal failure was assessed by measuring the concentration of serum creatinine. Serum IGF-I level was measured by radioimmunoassay. The mRNA expression in kidney was measured by RT-PCR. The distribution of IGF-I and CTGF was detected by immunohistochemistry. Resuts : Serum IGF-I concentration after one day following acute ischemic renal injury was significantly decreased compared to preischemic value. The mRNA levels of IGF-I, IGF-II, $TGF-{\beta}1$ and VEGF in whole kidney were temporally decreased on day one of ischemic injury. IGF-I and IGF-II expressions in outer medullae were significantly decreased on day one after ischemic injury. $TGF-{\beta}1$, CTGF and VEGF expressions were markedly decreased in medullae after one day of ischemic injury compared to other kidney sections. IGF-I was markedly decreased in cortical tubules on day one of uremic rat. CTGF was markedly increased on tubule within three days of ischemic injury. Conclusion : These findings suggest that IGFs, $TGF-{\beta}1$ and CTGF may involve in the pathogenesis or the recovery from acute ischemic renal injury.

Echocardiographic Parameters of Pulmonary Atresia with Intact Ventricular Septum(PA/IVS) (심실 중격 결손을 동반하지 않은 폐동맥 폐쇄 환아에서의 심초음파 계측치)

  • Lee, Young Seok;Kim, Yeo Hyang;Hyum, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.484-489
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    • 2003
  • Purpose : To understand morphologic and hemodynamic variations in patients with pulmonary atresia with intact ventricular septum(PA/IVS), and to decide the best treatment modalities, we measured right ventricular volume, inflow, and outflow valvular annulus size in these patients and compared them with those of normal newborns. Methods : Eight patients with PA/IVS diagnosed by echocardiography from January to December 2001 were enrolled in this study. Among the total eight patients, five were male and three were female. The mean age of patients was 6.9 days(1-34 days), and the mean body weight was 3,343 gm (2,970-4,000 gm). Ten fullterm newborn infants with sepsis or hyperbilirubinemia without heart disease were enrolled as a control group. Echocardiographic and Doppler studies using Acuson Aspen (7Mh probe) were recorded on super-VHS videotape and later on, with review mode. We measured volumes of right and left ventricles, aortic, pulmonic, mitral and tricuspid valvular annulus sizes using an installed program, and then these parameters were compared with those of the control group. Results : Mean Z-value of tricuspid valvular annulus in PA/IVS was $-3.69{\pm}2.80$(-8.4--0.45), and tricuspid/mitral valvular annulus size ratio $0.68{\pm}0.15$(0.43--0.84). The more the tricuspid/mitral valvular annulus size ratio, the more Z-value of tricuspid valvular annulus(P=0.003, r=0.885). Those patients who underwent pulmonary valvuloplasty(balloon or surgical) had a tendency toward larger volume of the right ventricle, more Z-value of pulmonic and tricuspid valvular annulus, and more tricuspid/mitral valvular annulus size ratio than those patients who underwent a shunt operation. Conclusion : Compared to a measurement of the volume of the right ventricle, measurements of tricuspid/mitral valvular annulus size ratio and Z-value of tricuspid valvular annulus may be easier and better parameters to decide the treatment method and to predict prognosis in PA/IVS patients.

A Study of Mo Back Electrode for CIGSe2 Thin Film Solar Cell (CIGSe2 박막태양전지용 Mo 하부전극의 물리·전기적 특성 연구)

  • Choi, Seung-Hoon;Park, Joong-Jin;Yun, Jeong-Oh;Hong, Young-Ho;Kim, In-Soo
    • Journal of the Korean Vacuum Society
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    • v.21 no.3
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    • pp.142-150
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    • 2012
  • In this Study, Mo back electrode were deposited as the functions of various working pressure, deposition time and plasma per-treatment on sodalime glass (SLG) for application to CIGS thin film solar cell using by DC sputtering method, and were analyzed Mo change to $MoSe_2$ layer through selenization processes. And finally Mo back electrode characteristics were evaluated as application to CIGS device after Al/AZO/ZnO/CdS/CIGS/Mo/SLG fabrication. Mo films fabricated as a function of the working pressure from 1.3 to 4.9mTorr are that physical thickness changed to increase from 1.24 to 1.27 ${\mu}m$ and electrical characteristics of sheet resistance changed to increase from 0.195 to 0.242 ${\Omega}/sq$ as according to the higher working pressure. We could find out that Mo film have more dense in lower working pressure because positive Ar ions have higher energy in lower pressure when ions impact to Mo target, and have dominated (100) columnar structure without working pressure. Also Mo films fabricated as a function of the deposition time are that physical thickness changed to increase from 0.15 to 1.24 ${\mu}m$ and electrical characteristics of sheet resistance changed to decrease from 2.75 to 0.195 ${\Omega}/sq$ as according to the increasing of deposition time. This is reasonable because more thick metal film have better electrical characteristics. We investigated Mo change to $MoSe_2$ layer through selenization processes after Se/Mo/SLG fabrication as a function of the selenization time from 5 to 40 minutes. $MoSe_2$ thickness were changed to increase as according to the increasing of selenization time. We could find out that we have to control $MoSe_2$ thickness to get ohmic contact characteristics as controlling of proper selenization time. And we fabricated and evaluated CIGS thin film solar cell device as Al/AZO/ZnO/CdS/CIGS/Mo/SLG structures depend on Mo thickness 1.2 ${\mu}m$ and 0.6 ${\mu}m$. The efficiency of CIGS device with 0.6 ${\mu}m$ Mo thickness is batter as 9.46% because Na ion of SLG can move to CIGS layer more faster through thin Mo layer. The adhesion characteristics of Mo back electrode on SLG were improved better as plasma pre-treatment on SLG substrate before Mo deposition. And we could expect better efficiency of CIGS thin film solar cell as controlling of Mo thickness and $MoSe_2$ thickness depend on Na effect and selenization time.

Evaluation on Usefulness of Applying Body-fix to Liver Cancer Patient in Tomotherapy (간암환자의 토모치료시 Body-fix 사용유무에 따른 유용성 평가)

  • Oh, Byeong-Cheon;Choi, Tae-Gu;Kim, Gi-Chul
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.1
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    • pp.11-18
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    • 2010
  • Purpose: In every time radiation therapy set up errors occur because internal anatomical organs move due to breathing and change of patient's position. These errors may affect the change of dose distribution between target area and normal structure. This study investigates the usefulness of body-fix in clinical treatment. Materials and Methods: Among 55~60 aged male patients who has hepatocellular carcinoma in area of liver's couinaud classification, we chose 10 patients and divided two groups by using body-fix or not. When applying body-fix, we maintained a vacuum of 80 mbar pressure by using vacuum pump (Medical intelligence, Germany). Patients had free breathing with supine position. After working to fuse and consist MV-CT (megavoltage computed tomography) with KV-CT (kilovoltage computed tomography) obtained by 5 times treatments, we compared and analyzed set up errors occurred to (Right to Left, RL) of X axis, (Anterioposterio, AP) of Z axis, (Cranicoudal, CC) of Y axis. Results: Average Set up errors through image fusion showed that group A moved $0.3{\pm}1.1\;mm$ (Cranicoudal, CC), $-1.1{\pm}0.7\;mm$ (Right to Left, RL), $-0.2{\pm}0.7\;mm$ (Anterioposterio, AP) and group B moved $0.62{\pm}1.94\;mm$ (Cranicoudal, CC), $-3.62{\pm}1.5\;mm$ (Right to Left, RL), $-0.22{\pm}1.2\;mm$ (Anterioposterio, AP). Deviations of X, Y and Z axis directions by applying body-fix indicated that maximum X axis was 5.5 mm, Y axis was 19.8 mm and Z axis was 3.2 mm. In relation to analysis of error directions, consistency doesn't exist for every patient but by using body-fix showed that the result of stable aspect in spite of changes of everyday's patient position and breathing. Conclusion: Using body-fix for liver cancer patient is considered effectively for tomotherapy. Because deviations between group A and B exist but they were stable and regular.

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The Study on Properties and Application of Enhanced Dynamic Wedge Factor (향상된 동적쐐기인자(Enhanced Dynamic Wedge Factor)의 특성 및 적용에 관한 고찰)

  • Kim, Dae-Sup;Ban, Tae-Joon;Yeom, Mi-Suk;Yoo, Soon-Mi;Lee, Woo-Seok;Back, Geum-Mun;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.1
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    • pp.53-60
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    • 2010
  • Purpose: We try to calculate EDW-factor easily with the formula applies essential data of EDW-factor and evaluate the validity through a measurement. Materials and Methods: We used the given value of GSTT (Golden Segmented Treatment Table) for the calculation of the EDW-factor. As to the experimental device, 0.6 cc farmer-type ion-chamber, an electrometer and water- phantom were used. A measurement was made at the maximum dose depth of the photon beam energy 6 MV and 15 MV under the condition that SSD (Source to Surface Distance) was 100 cm. The angle of the EDW (Enhanced Dynamic Wedge) which we use in an experiment was 60 degree, 30 degree, 20 degree in the Y1-OUT direction. We used Eclipse planning system (Varian, USA) as RTP system and the EDW-factor was calculated about all fields and EDW direction. In order to show the EDW-factor feature, a measurement was made at the selected field that verify the influence of the dependability about X, Y jaw and off-axis field. Results: When we change the Y1 field, it influence on the EDW-Factor and measured value. But the error between measured values and calculated values was less than 1%. The experimental result indicated the tendency that the error of the result of calculation and measured value becomes smaller as the EDW angle become smaller whether the calculation point (measurement point) and iso-center are same or not. The influence of the field size and energy did not show up. We simulated with the same condition using the RTP system. And we found that it makes no difference between the MU which is calculated manually by applying the EDW-Factor obtained from the commercial program and the value which is calculated by using RTP system. Conclusion: We excluded fitting value from well-known EDW-Factor formula and calculated EDW-factor with the formula applies essential data of EDW-factor only. As a result, there are no significant difference between the measured value and calculated value and it showed errors less than 1%. Also, we implemented the commercial program to calculate EDW-Factor conveniently without measure a factor on each field.

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Study of Absorbed Dose and Effective Dose for Prostate Cancer Image Guided Radiation Therapy using kV Cone Beam Computed Tomography (kV Cone Beam Computed Tomography (CBCT)를 이용한 전립선암 영상유도방사선치료 시 흡수선량 및 유효선량에 관한 고찰)

  • Na, Jong-Eok;Lee, Do-Geun;Kim, Jin-Soo;Baek, Geum-Mun;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.67-74
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    • 2009
  • Purpose: To evaluate the results of absorbed and effective doses using two different modes, standard mode (A-mode) and low-dose mode (B-mode) settings for prostate cancer IGRT from CBCT. Materials and Methods: This experimental study was obtained using Clinac iX integrated with On Board Imager (OBI) System and CBCT. CT images were obtained using a GE Light Speed scanner. Absorbed dose to organs from ICRP recommendations and effective doses to body was performed using A-mode and B-mode CBCT. Measurements were performed using a Anderson rando phantom with TLD-100 (Thermoluminescent dosimeters). TLD-100 were widely used to estimate absorbed dose and effective dose from CBCT with TLD System 4000 HAWSHAW. TLD-100 were calibrated to know sensitivity values using photon beam. The measurements were repeated three times for prostate center. Then, Evaluations of effective dose and absorbed dose were performed among the A-mode and B-mode CBCT. Results: The prostate absorbed dose from A-mode and B mode CBCT were 5.5 cGy 1.1 cGy per scan. Respectively Effective doses to body from A mode and B-mode CBCT were 19.1 mSv, 4.4 mSv per scan. Effective dose from A-mode CBCT were approximately 4 times lower than B-mode CBCT. Conclusion: We have shown that it is possible to reduce the effective dose considerably by low dose mode(B-mode) or lower mAs CBCT settings for prostate cancer IGRT. Therefore, we should try to select B-mode or low condition setting to decrease extra patient dose during the IGRT for prostate cancer as possible.

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Implementation of Man-made Tongue Immobilization Devices in Treating Head and Neck Cancer Patients (두 경부 암 환자의 방사선치료 시 자체 제작한 고정 기구 유용성의 고찰)

  • Baek, Jong-Geal;Kim, Joo-Ho;Lee, Sang-Kyu;Lee, Won-Joo;Yoon, Jong-Won;Cho, Jeong-Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.1
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    • pp.1-9
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    • 2008
  • Purpose: For head and neck cancer patients treated with radiation therapy, proper immobilization of intra-oral structures is crucial in reproducing treatment positions and optimizing dose distribution. We produced a man-made tongue immobilization device for each patient subjected to this study. Reproducibility of treatment positions and dose distributions at air-and-tissue interface were compared using man-made tongue immobilization devices and conventional tongue-bites. Materials and Methods: Dental alginate and putty were used in producing man-made tongue immobilization devices. In order to evaluate reproducibility of treatment positions, all patients were CT-simulated, and linac-gram was repeated 5 times with each patient in the treatment position. An acrylic phantom was devised in order to evaluate safety of man-made tongue immobilization devices. Air, water, alginate and putty were placed in the phantom and dose distributions at air-and-tissue interface were calculated using Pinnacle (version 7.6c, Phillips, USA) and measured with EBT film. Two different field sizes (3$\times$3 cm and 5$\times$5 cm) were used for comparison. Results: Evaluation of linac grams showed reproducibility of a treatment position was 4 times more accurate with man-made tongue immobilization devices compared with conventional tongue bites. Patients felt more comfortable using customized tongue immobilization devices during radiation treatment. Air-and-tissue interface dose distributions calculated using Pinnacle were 7.78% and 0.56% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Dose distributions measured with EBT (international specialty products, USA) film were 36.5% and 11.8% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Values from EBT film were higher. Conclusion: Using man-made tongue immobilization devices made of dental alginate and putty in treatment of head and neck cancer patients showed higher reproducibility of treatment position compared with using conventional mouth pieces. Man-made immobilization devices can help optimizing air-and-tissue interface dose distributions and compensating limited accuracy of radiotherapy planning systems in calculating air-tissue interface dose distributions.

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Robust Planning of Intensity-modulated Proton Therapy for Prostate Cancer (전립선암 치료를 위한 세기조절 양성자 로버스트 치료계획)

  • Park, Su Yeon;Kim, Jong Sik;Park, Ju Young;Park, Won;Ju, Sang Gyu
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.25-31
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    • 2013
  • Purpose: The aim of this study is to evaluate the dosimetric properties of robust planning strategy for plain intensity-modulated proton therapy (IMPT) taking into account of the uncertainties of effective proton range and set up error as compared to photon intensity-modulated radiation therapy (photon-IMRT) in prostate cancer treatment. Materials and Methods: The photon-IMRT (7 beams, step & shoot), plain-IMPT (2, 4, and 7 portals), and robust- IMPT plans, which was recalculated the plain-IMPT based on the uncertainties of range error (${\pm}5%$) and set up error (0.5 cm), were evaluated for five prostate cancer patients prescribed by 70 Gy/35 fractions. To quantitatively evaluate the dose distributions, several parameters such as maximum dose, minimum dose, mean dose, conformity index (CI), and homogeneity index (HI) for PTV as well as dose-volume index of VxGy for OARs were calculated from dose-volume histograms. Results: Robust-IMPT showed superior dose distributios in the PTV and OARs as compared to plain-IMPT and photon-IMRT. Like plain-IMPT, robust-IMPT were resulted in dose fluctuation around OARs, while better homogeneity and conformity in PTVs and lower mean dose in OARs as compared to photon-IMRT. Conclusion: In consideration with the effective range correction and set up movement using robustness in IMPT plan, the dosimetric uncertainties from plain-IMPT could substantially reduce and suggest more effective solutions than photon-IMRT in prostate cancer treatment.

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Effectiveness of Soft Stimulation Protocol, Compared with Conventional GnRH Antagonist Multiple dose Protocol in Patients Undergoing Controlled Ovarian Stimulation with Intrauterine Insemination (과배란유도하 자궁강내 인공수정시술을 받는 환자에서 연성자극요법과 성선자극호르몬 길항제 다회투여법의 효과 비교)

  • Kim, Chung-Hoon;Kang, Hyuk-Jae;Kim, So-Ra;Jeon, Gyun-Ho;Lee, Hyang-Ah;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.135-142
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    • 2010
  • Objective: To evaluate the effectiveness of soft stimulation protocol using GnRH antagonist/clomiphene citrate (CC)/recombinant FSH (rFSH) in patients undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI), compared with GnRH antagonist multiple dose protocol (MDP) using GnRH antagonist/rFSH. Methods: Eighty infertile women were randomized to soft stimulation protocol group (n=40) or GnRH antagonist MDP group (n=40). In both groups, IUI was performed 36~40 hours after hCG injection. Statistical analysis was performed using Student's t-test, $\chi^2$ test or Fisher's exact test as appropriate. Results: Total dose and days of rFSH required for COS were significantly fewer in soft stimulation protocol group (p<0.001, p<0.001). A premature LH surge did not occur in any patients of both groups. Clinical pregnancy rate per cycle was similar between the two groups. Conclusion: Soft stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP despite fewer total dose and days of rFSH, and so can become one of the patient-friendly, cost-effective alternatives for infertile patients undergoing COS with IUI.

Pain reduction at venipuncture in newborn infants : oral glucose solution, EMLA cream and pacifiers (신생아의 정맥천자시 통증 감소 효과 : 경구 포도당액, EMLA 크림 및 노리개 젖꼭지)

  • Park, Sang Kee;Kim, Eun Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.388-393
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    • 2006
  • Purpose : We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants. Methods : Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale. Results : There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A : $12.5{\pm}2.5$, B : $10.1{\pm}2.6$, C : $9.4{\pm}2.0$, D : $6.5{\pm}2.1$ and E : $8.7{\pm}2.3$; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A : 100 percent, B : 82 percent, C : 56 percent, D : 40 percent and E : 70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A : 72 percent, B : 30 percent, C : 22 percent, D : 0 percent and E : 14 percent; that of group D was clearly lowest. Conclusion : These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.