• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.4
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• pp.1751-1758
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• 2012

Capillary blood sampling on the forearm reduces pain caused by skin puncture. The present study compared the blood glucose test results performed at different sampling sites of the forearm, finger, and vein to evaluate clinical validity of this alternative site blood sampling technique. Subjects numbered 555 including 61 diabetic patients participated to measure the glucose concentration on the finger ($G_F$) and the forearm ($G_A$) with a portable glucometer under overnight fasting state. Then, the venous glucose concentration ($G_V$) was measured in 514 subjects in less than 1 hour. The test results were analyzed by simple linear regression, intraclass correlation, and Passing-Bablok regression techniques. $G_A$ was highly correlated with $G_F$ or $G_V$ showing the correlation coefficients (r) of approximately 0.97 (P<0.0001) in the normal group. The patient group also resulted similarly high correlation with only slightly lower r value. The mean differences in glucose concentration were less than ${\pm}10mg/dL$ regardless of the sampling sites. Intraclass correlation coefficients were slightly smaller than r but very much similar in value in both groups. The 95% confidence intervals of the slope as well as the intercept in the Passing-Bablok regression analysis were < ${\pm}20%$ and < ${\pm}20mg/dL$, respectively, which were within the clinically acceptable ranges. These three statistical techniques introduced in the present study well demonstrated the consistency of $G_A$ with $G_F$ and $G_V$. Therefore, the forearm blood glucose test could be considered as clinically valid under fasting condition.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.66-74
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• 2003

Purpose : The matrix metalloprotelnases (MMPs) are a family of enzymes whose main function is the degradation of the extracellular matrix. Several studies have revealed that MMPs and TIMPS are related to the wound heating process and in photoaging caused by ultraviolet Irradiation. However, the expressions of MMP and TIMP after irradiation have not, to the best of our knowledge, been studied. This study investigates the expressions of MMP-2 and TIMP-2 in rat Intestinal mucosa following irradiation. Materials and Methods : The entire abdomen of Sprague-Dawley rats was irradiated using a single dose method. The rats were sacrificed on day 1, 2, 3, 5, 7 and 14 following irradiation. Histopathological observations were made using hematoxilin & eosin staining. The expressions of MMP-2 and TIMP-2 were examined using immunohistochemistry, Irnrnunoblotting and ELISA. Results : Radiation induced damage associated with atrophic villi, and infiltration of inflammatory cell was observed from the first postirradiation day, and severe tissue damage was observed on the second and the third postirradiation days. An increase in mitosis and the number of regenerating crypts, as evidence of regeneration, were most noticeable on the fifth postirradiation day. From the immunohistochemlstry, the MMP-2 expression was observed from the first postirradiation day, but was most conspicuous on the third and the fifth postirradiation days. The TIMP-2 expression was most conspicuous on the fifth postirradiation day. From the irnrnunoblotting, the MMP-2 expression was strongly positive on the third postirradlatlon day, and that of TIMP-2 showed a strong positive response on the fifth postirradiation day. In ELISA tests, the expressions of MMP-2 and TIMP-2 were increased in the postirradiation groups compared to those of the normal controls, and showed a maximum increase on the fifth postirradiatlon day. These results were statistically significant. Conclusion : The expressions of MMP-2 and TIMP-2 were increased in the intestinal mucosa of the rats following irradiation, and these results correlated with the histopathological findings, such as tissue damage and regeneration. Therefore, this study suggests that MMP-2 and TIMP-2 play roles in the mechanisms of radiation-induced damage and regeneration of intestinal mucosa of rats.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.167-172
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• 2006

Purpose: The laparoscopy assisted gastrectomy has been increasingly reported as the treatment of choice for early gastric cancer. However, expert surgeons, who have performed a conventional open gastrectomy for a long time, tend to have a negative attitude toward laparoscopic procedures. The aim of this study was to determine the learning curve of a laparoscopy assisted distal gastrectomy (LADG) for a surgeon expert in performing an open gastrectomy and to analyze the factors that have an effect on a LADG. Materials and Methods: Between April 2005 and March 2006, 62 patients underwent a LADG with D1+beta lymph-node dissection. The 62 patients were divided into 10 sequential groups with 6 cases in each group (the last group was 8 cases), and the time required to reach the plateau of the learning curve was determined by examining the average operative times of these 10 groups. Other factors, such as sex, BMI, complications, transfusion requirements, the number of retrieved lymph nodes, and change of postoperative hemoglobin level, were also analyzed. Results: With the $5^{th}$ group (after 30 cases), the operative time reached a plateau (average: 170 min/operation). The differences between before the $30^{th}$ case and after the $31^{st}$ case with respect to changes in the postoperative hemoglobin level, the number of retrieved lymph nodes, the transfusion requirements, and the complications rate were not significant. Conclusion: According to an analysis of the operative time, experience with 30 LADGs in patients with early gastric cancer is the point at which the plateau of the learning curve (7 months) is reached. Abundant experience with a conventional open gastrectomy and a well-organized laparoscopic surgery team are important factors in overcoming the learning curie earlier.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.215-221
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• 2007

The aim of this study was to test whether metric measurements of crown length, root length and apex width during tooth development could be a better basis for correlation with age than the classical methods based on subjective estimations of various stages of tooth development. Panoramic radiographs of 120 children, aged 7 to 9 years, were collected from the department of the pediatric dentistry of Chonnam National University Hospital, Korea. The methods of Mornstad was used to estimate age. The structures measured were crown length root length and apex width in panoramic radiographic. The results were as follows : 1. In the boys, it showed higher correlation between lower 2nd molar crown length, lower 1st molar root length or lower 1st permolar apical width and age. In the girls, it showed higher correlation between lower 2nd premolar crown length, lower 2nd molar root length or lower 1st molar apical width and age. 2. With the aid of a multiple regression model, a linear relationship between some of these distances and age was shown. Boy(months) = 43.958 + lower 2nd molar crown length ${\times}$ 4.392 + lower 1st molar root length ${\times}$ 2.255 - lower 1st permolar apical width ${\times}$ 2.046, Girl(months) = 75.213 + lower 2nd premolar crown length ${\times}$ 3.910 lower 2nd molar root length ${\times}$ 2.280 - lower 1st molar apical width ${\times}$ 6.217 Age was estimated in boys and girls using the mathematic model ; the mean difference between chronological and estimated ages was $-2.1{\pm}6.8$ months for boys and $6.1{\pm}6.2$ months for girls. Therefore, it seems to be more accurate and easier than the earlier methods.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.32-40
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• 2007

Purpose : We performed this study to determine the incidence of acute renal failure(ARF) in birth asphyxia and to correlate the severity of asphyxia and hypoxic-ischemic encephalopathy (HIE) and ARF in asphyxiated neonates. Methods : Data was retrospectively collected from the medical records of 33 patients with neonatal asphyxia and of 33 neonates with no asphyxia. On the basis the 5-minute Apgar score, the asphyxiated neonates were further grouped into mild(6 or 7), moderate(4 or 5), and severe asphyxia(3 or less). Asphyxiated neonates with HIE were staged by the Sarnat and Sarnat scoring system. We compared serum creatinine, blood urea nitrogen, electrolytes, and urine output on day 3 of life and the incidence and severity of intraventricular hemorrhage(IVH) between each group. Results : ARF occurred in 8(24.2%) asphyxiated neonates. Of these, 3(37.5%) were oliguric, while 1(10.0%) patient with mild asphyxia, 2(18.2%) of moderate asphyxia, and 5(41.7%) with of severe asphyxia had ARF(P>0.05). One(25%) patient with stage I HIE, 4(50%) with stage II HIE, and 3(75%) of HIE with stage III HIE developed ARF(P<0.01). There was no statistical correlation between the severity of asphyxia and HIE stage. One(7.7%) patient with grade 1 IVE, 0(0.0%) with grade 2 IVH, 2(66.7%) with grade 3 IVH, and 2(100.0%) with grade 4 IVH had ARF(P<0.01). Mortality was higher in asphyxiated neonates with ARF(P<0.05). There was no significant difference between the oliguric and non-oliguric renal failure. Conclusion : We found that the greater the degree of HIE, the higher was the incidence of ARF. Asphyxiated neonates with ARF had a poorer prognosis.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.81-86
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• 2012

Purpose : Combined MR/PET scanners that use the MRI for PET AC face the challenge of absent surface coils in MR images and thus cannot directly account for attenuation in the coils. To make up for the weak point of MR attenuation correction, Three Modality System (PET/CT +MR) were used in Severance hospital. The goal of this work was to investigate the effects of MR Torso Coil on CT attenuation correction for PET. Materials and Methods : PET artifacts were evaluated when the MR Torso Coil was present of CTAC data with changing various kV and mA in uniformity water phantom and 1994 NEMA cylinderical phantom. They evaluated and compared the following two scenarios: (1) The uniform cylinder phantom and the MR Torso Coil scanned and reconstructed using CT-AC; (2) 1994 NEMA cylinderical phantom and the MR Torso Coil scanned and reconstructed using CT-AC. Results : Streak artifacts were present in CT images containing the MR Torso Coil due to metal components. These artifacts persisted after the CT images were converted for PET-AC. CT scans tended to over-estimate the linear attenuation coefficient when the kV and mA is increasing of the metal components when using conventional methods for converting from CT number. Conclusion : The presence of MR coils during PET/CT scanning can cause subtle artifacts and potentially important quantification errors. Alternative CT techniques that mitigate artifacts should be used to improve AC accuracy. When possible, removing segments of an MR coil prior to the PET/CT exam is recommended. Further, MR coils could be redesigned to reduce artifacts by rearranging placement of the most attenuating materials.

• Radiation Oncology Journal
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• v.20 no.2
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• pp.93-99
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• 2002

Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.207-213
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• 1997

Purpose : Intracranial germinoma is the most radiocurable tumor of theprimary intracranial neoplasm. But, the optimum radiation dose and target volume remain controversial In this retrospective study, we analysed the spreading pattern at presentation and the pattern of the failure and survival of intracranial germinoma, Materials and Methods : From 1989 to 1996, 23 Patients were treated for intracranial germinoma at Department of Radiation Oncology, Twenty-one Patients were treated at their initial Presentation and 2 Patients were treated for recurrent disease. Six patients had multiple tumor masses on MRI and 7patients had ventricular seeding on MRI. The examination of cerebrospinal fluid cytology was done in 15 patients and 3 out of 15 patients had positive cerebrospinal cytology. In tumor marker study of $\alpha-FP\;and\;\beta-hCG$, 6 patients had mildly elevated $\beta-hCG$ in serum or cerebrospinal fluid. Twentyone Patients were treated with whole craniospinal axis irradiation and 2 Patients were given whole ventricular radiation therapy. The total dose was ranged between 4500cGy and 5600cGy to primary tumor site (median 5580cGy) Dose to the entire ventricular system ranged from 1980cGy to 3960 cGy (median 2700cGy) and dose to the spinal axis ranged from 2160cGy to 3900cGy (median 2700cGy) Results : Of 23 patients, 21 Patients are alive without evidence of diseasefor median 4 years follow-up. One Patient who had markedly elevated $\alpha-FP\;and\;\beta-hCG$, suffered from Persistent disease after radiation therapy and received 2 cycles of chemotherapy. She died 9 months after chemotherapy One patient who developed ventricular seeding after gamma-knife was treated with whole craniospinal irradiation, he died after 1 year due to probably brain necrosis. The hematologic toxicity of 3 or 4 grade were seen in 7 patients and patient's endocrinologic dysfunction was not deteriorated after radiation therapy. One patient had been treated with growth hormone replacement due to short stature. Conclusions : This retrospective study has confirmed the excellent result of radiation therapy in intracranial germinoma. The complication rate during or after radiation therapy is considered within acceptable range. ft is necessary to further investigate the optimal dose and treatment volume of radiation therapy. The role of chemotherapy in the treatment of intracranial germinoma should be further investigated.

• Tuberculosis and Respiratory Diseases
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• v.56 no.2
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• pp.159-168
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• 2004

Background : In recent years, numerous human tumor specific antigens such as melanoma antigen gene(MAGE) that is recognized by autologous cytotoxic T lymphocytes have been identified. MAGE is expressed in many human malignancies in various organs, such as lung, breast, stomach, esophagus and leukemia. Therefore MAGE has been studied widely for tumor diagnosis and immunotherapy. But, so far there were no clinical studies evaluating the role of MAGE in pleural effusion. We investigated the expression of MAGE in the patients with exudative pleural effusion for it's diagnostic utility and the results were compared with those of cytologic examinations. Methods : Diagnostic thoracentesis was performed in 44 consecutive patients with exudative pleural effusion during 6 months. We examined the expression of MAGE and cytology with the obtained pleural effusion. Expression of MAGE was interpreted by means of a commercial kit using RT-PCR method. Enrolled patients were divided into two groups such as malignant and benign and we analyzed its' sensitivity and specificity. Results : There were no significant differences between two groups in age, sex, white blood cell counts in pleural fluid, pleural fluid/serum protein ratio and pleural fluid/serum LDH ratio. The sensitivity and specificity of MAGE were 72.2% and 96.2% respectively and the positive predictive value and negative predictive value of MAGE were also 92.9% and 83.3% respectively. The sensitivity and negative predictive value of cytologic examinations were 66.7% and 81.3% respectively. There were no significant differences between sensitivities of MAGE and cytologic examinations but false positive result of MAGE was found in 1 case of tuberculous pleurisy. Conclusion : MAGE is a sensitive and specific marker for the differential diagnosis between benign and malignant effusion in patients with exudative pleural effusion. And MAGE would provide the equal sensitivity compared with that of cytologic examination in patients with malignant pleural effusion if 5mL of the pleural fluid is examined.

• Journal of the Korean earth science society
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• v.26 no.3
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• pp.283-296
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• 2005

The effect of ozone and surface temperature on the ozone band at $9.7{\mu}m$ has been investigated from radiative transfer theory together with observations in order to derive empirical methods for remotely sensing ground-ozone concentration. Simultaneous observations of satellite (MODIS Aqua; ECT 13:30) and ground-ozone at 79 stations have been used over the Seoul Metropolitan Area (SMA; 125.7-127.2 E, 37.2-37.7 N) during four ozone-warning days in the year 2003. Cloud effect on the band in the methods was filtered out based on synoptic observations. Upwelling radiance values at $9.6{\mu}m$ which have been estimated at the given ozone concentration of 327-391 DU depend on surface temperature (Ts) showing $5.52\~5.78Wm^{-2}sr^{-1}\;at\;Ts = 290 K,\;and\;9.00\~9.57Wm^{-2}sr^{-1}$ Ts = 325K. Thus, the partitioned contributions of ozone and temperature to intensity of ozone absorption band are $0.26Wm^{-1}sr^{-1}/64\;DU\;and\;0.31 Wm^{-2}sr^{-1}/35K$, respectively. Here the intensity which has been used to remotely detect ground-ozone concentration from infrared satellite measurement is defined as the difference in brightness temperature between $11{\mu} m\;and\;9.7{\mu}m (i.e.,\; T_{11-9.7})$. The methods in this study have been applied to estimate ground-ozone from MODIS data in cases that there are significant correlations between the band intensity and ground-ozone. The values of estimated ozone significantly correlate (0.49-0.63) with ground observations at a significance level of $1\%$. For the improved methods, further study may be required to use tropospheric ozone rather than ground-ozone, considering the variation stratospheric ozone.