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Hyperfractionation Radiation Therapy in Advanced Head and Neck Cancer (진행된 두경부암에서 다분할 방사선치료)

  • Kim, Jin-Hee;Ye, Ji-Won
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.112-117
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    • 2003
  • Purpose: The effects of hypefractionation radiation therapy, such as the failure pattern and survival, on the treatment results in advanced stage head and neck cancer were studied. Materials and Methods: Between September 1990 and October 1998, 24 patients with advanced stage (III, IV) head and neck cancers, were treated using hyperfractionation radiation therapy in the Department of Radiation Oncology at the Keimyung University Dongsan Medical Center. The male to female ratio was 7 : 1, and the age range from 38 to 71 years with the median of 56 years. With regard to the TNM stage, 11 patients were stage III and 13 were stage IV. The sites of primary cancer were the nasopharynx in six, the hypopharynx in 6, the larynx in five, the oropharynx in three, the maxillary sinus in three, and the oral cavity in one patient. The radiotherapy was delivered by 6 MV X-ray, with a fraction size of 1.2 Gy at two fractions a day, with at least 6 hours inter-fractional interval. The mean total radiation doses was 72 Gy, (ranging from 64.4 to 75.8 Gy). Follow-up periods ranged between 3 and 136 months, with the median of 52 months. Results: The overall survival rates at 3 and 5 years in all patients were 66.7$\%$, and 52.4$\%$. The disease-free survival rates at 3 and S years (3YDFS, 5YDFS) in all patients were 66.7$\%$ and 47.6$\%$. The 3YDFS and 5YDFS in stage III patients were 81.8$\%$ and 63.6$\%$, and those in stage IV patients were 53.8$\%$ and 32.3$\%$. Ten patients were alive with no local nor distant failures at the time of analyses. Six patients (25$\%$) died due to distant metastasis and 12.5$\%$ died due to local failure. Distant metastasis was the major cause of failure, but 2 patients died due to unknown failures and 3 of other diseases. The distant metastasis sites were the lung (3 patients), the bone (1 patient), and the liver (2 patients). One patient died of second esophageal cancer. There were no severe late complications, with the exception of 1 osteo-radionecrosis of the mandible 58 months after treatment. Conclusion: Although this study was peformed on small patients group, we considered hypefractionated radiation therapy for the treatment of advanced stage head and neck cancer might improve the disease free survival and decrease the local failure with no increase in late complications despite of the slight Increase in acute complications.

The Design and Fabrication of Conversion Layer for Application of Direct-Detection Type Flat Panel Detector (직접 검출형 평판 검출기 적용을 위한 변환층 설계 및 제작)

  • Noh, Si-Cheol;Kang, Sang-Sik;Jung, Bong-Jae;Choi, Il-Hong;Cho, Chang-Hoon;Heo, Ye-Ji;Yoon, Ju-Seon;Park, Ji-Koon
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.73-77
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    • 2012
  • Recently, Interest to the photoconductor, which is used to flat form X-ray detector such as a-Se, $HgI_2$, PbO, CdTe, $PbI_2$ etc. is increasing. In this study, the film layer by using the photoconductive material with particle sedimentation was fabricated and evaluated. The quantization efficiency of the continuous X-ray with the 70 kVp energy bandwidth was analyzed by using the Monte Carlo simulation. With the results, the thickness of film with 64 % quantization efficiency was 180 ${\mu}m$ which is similar to the efficiency of 500 ${\mu}m$ a-Se film. And $HIg_2$ film has the high quantization efficiency of 74 % on 240 ${\mu}m$ thickness. The electrical characteristics of the 239 ${\mu}m$ $Hgl_2$ films produced by particle sedimentation were shown as very low dark current(under 10 $pA/mm^2$), and high sensitivity(19.8 mC/mR-sec) with 1 $V/{\mu}m$ input voltage. The SNR, which is influence to the contrast of X-ray image, was shown highly as 3,125 in low driving voltage on 0.8 $V/{\mu}m$. With the results of this study, the development of the low-cost, high-performance image detector with film could be possible by replacing the film produced by particle sedimentation instead to a-Se detector.

Development of a Mobile Application for Promoting Risk Communication on Food Additives Based on the Information Needs of Parents (학부모의 정보요구도에 기초한 식품첨가물 위해정보전달 스마트폰 애플리케이션의 개발)

  • Kim, Suna;Kim, Ye jee;Kim, Ji-Sun;Kim, Jeong-Weon
    • Journal of Food Hygiene and Safety
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    • v.30 no.2
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    • pp.132-142
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    • 2015
  • The purpose of this study was to investigate the perception and information needs about food additives from the parents of elementary school children, and to develop a smartphone application (App) providing information about food additives, and finally to assess its educational effects. A survey was conducted in April 2013 by using a self-administered questionnaire, and total 358 responses were collected from the parents living in Seoul and Gyeonggi province. While purchasing processed foods, parents considered safety (40.5%) as the most important factor, and first checking item except production and expiration dates was origin labelling (35.4%), and chose foods with less food additives (63.1%). Parents recognized food additives as the most dangerous (42.7%), and 75.1% responded the level of danger as 'very dangerous'. However, 82.4% of parents didn't have experiences to get educations about food additives. Based on their information needs including the safety, legal standards and the foods containing food additives. a smartphone App designated as 'Catch up Food Additives' consisting of the definition, safety, food labelling guideline, management, animation about food additives was developed. When the App was exposed to the parents (n = 27), their negative perceptions on food additives were improved significantly. These results showed that providing information and education about food additives using smartphone App was very fast and effective for the promotion of risk communication on food additives with the parents.

Intake Status and Recognition of Health Functional Foods by Pre- and Post-Menopausal Women in Seoul and Gyeonggi Province (서울·경기지역 폐경 전후 여성의 건강기능성식품 섭취 실태 및 인지도 조사 연구)

  • Park, Keun-Cheol;Choi, Yoon-Hye;Kim, Woo-Rim;Choi, Ye-Ji;Yoon, Ki Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.7
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    • pp.1112-1121
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    • 2014
  • The purpose of this study was to investigate intake status and recognition of health functional foods by pre- and post-menopausal women in Seoul and Gyeonggi province. Survey questions were administered to 400 women around menopausal period, and data analysis was completed using the SPSS window program. Thirty-three percent of women recognized that they are healthy, and 47.1% of respondents are concerned with maintaining their health. However, respondents showed a low level of knowledge about the definition of menopause and health functional foods. Health concerns of respondents were significantly affected by marital status and level of education (P<0.05). Purchasing and intake of health functional foods was also significantly affected by health concerns and menopause symptoms (P<0.05). Twenty-nine percent of participants had taken health functional foods to prevent disease. However, most of them (85.9%) showed no knowledge of the main components of functional foods. In addition, knowledge associated with menopause and functional foods was affected by the level of education. The respondents' health concern, and thus purchase and intake frequencies of health functional foods, were affected by level of education. 'Effect of functional foods' was a top priority when respondents purchased health functional foods. The respondents answered black bean and pomegranate as foods that relieve menopause symptoms. However, they actually showed high intake frequency of black beans than pomegranate due to the high accessibility of black beans. The results of this study show that educational support for dietary guidelines is needed for middle-aged woman to be healthy after menopause.

The Biological Stability of Immediate Placement of Tapered Implants in Tooth Extraction Sites (발치와에 즉시 식립한 쐐기형 임플란트의 생물학적 안정성에 관한 전향적 연구)

  • Park, Ja-young;Bae, Ahran;Kim, Hyung-Seub;Kwon, Yong-Dae;Lee, Baek-Soo;Kwon, Kung-Rock
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.2
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    • pp.139-155
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    • 2009
  • Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.

Clinical Characteristics and Treatment Results of Neuroendocrine Carcinoma of Uterine Cervix (자궁경부 신경내분비암의 임상적 특징과 치료 결과)

  • Kim, Ok-Bae;Kim, Jin-Hee;Cha, Soon-Do;Choi, Tae-Jin;Ye, Ji-Won
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.124-129
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    • 2004
  • Purpose : To evaluate the clinical findings, prognosis and treatment strategy of patients with neuroendocrine carcinoma of cervix. Materials and Methods: Thirteen patients with neuroendocrine carcinoma of cervix were included in this study, as confirmed histologically and immunohistochemically at the Dongsan Medical Center, Keimyung University, between May 1944 and October 2001. The mean age of patients was 56 years with a range of 32 to 78 years of age. According to the FIGO staging system, there were 5 patients with stage IB carcinoma, 5 patients with IIA, and 3 patients with stage IIB. Four patients underwent radical hysterectomy with pelvic lymphadenectomy, 3 of these patients also received postoperative radiotherapy, and one patient underwent extrafascial hysterectomy after radiotherapy. Primary radiotherapy was done in 9 patients, and 3 were irradiated postoperatively. Nine patients received chemotherapy, 7 received neoadjuvant and 2 received concurrent chemoradiotherapy. The radical purpose of radiotherapy consisted of external irradiation to the whole pelvis (4,500 $\~$5,400 cGy) and intracavitary irradiation (3,000 $\~$ 3,500 cGy). Results : The mean follow up duration was 36 months with a range of 3 to 104 months. The overall 5-year survival rate was 61.5$\%$ and the 5-year survival rates for stage IB, IIA, IIB were 60.0$\%$, 60.0$\%$, and 66.7$\%$ respectively (p=0.99). Eight patients are still alive without disease, and all of the 5 patients with recurrence are dead due to distant metastasis. Conclusion : Neuroendocrine carcinoma of cervix is highly aggressive, with early lymphatic dissemination and a high rate of distant recurrence. Therefore, an aggressive therapeutic strategy Is required to obtain pelvic and distant disease control. Multimodal therapy should be considered at the time of Initial diagnosis.

Comparison of Pakistani Ephedra Herba and Chinese Ephedra Herba Containing Gangjihwan in the Improvement Effects of Weight Loss in a High Fat Diet-Fed Obese Mice (고지방식이 비만마우스 모델에서 파키스탄산 및 중국산 마황으로 조성된 강지환(降脂丸)의 체중감량 효과 비교)

  • Kim, Byeong Chul;Seok, Hoa Jun;Yoo, Jae Sang;Ku, Ja Ryong;Yoon, Ki Hyeon;Jo, Ju Heum;Jang, Du Hyon;Jung, Yang Sam;Kim, Jong Hoon;Ahn, Ye Ji;Woo, Sangee;Yoon, Miso;Shin, Soon Shik
    • Herbal Formula Science
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    • v.22 no.2
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    • pp.63-76
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    • 2014
  • Objectives : This study investigated the improvement effects of Pakistani (DF-a) and Chinese Ephedra herba-containing Gangjihwan (DF-b) on obesity in a high fat diet-fed obese mouse model. Methods : Eight-week-old C57BL/6N mice were divided into four groups: a normal lean group given a standard diet, an obese control group given a high fat diet, and DF-a and DF-b groups given a high fat diet with DF-a (80 mg/kg), and DF-b (80 mg/kg), respectively. After 8 weeks of treatment, body weight gain, feeding efficiency ratio, blood lipid markers, fat weight and histology were examined. Results : 1. Body weight gain and fat mass were significantly decreased in DF-a and DF-b groups compared with control. The extent of decreases was eminent in DF-a group. 2. Feeding efficiency ratio and circulating leptin concentration were significantly decreased in DF-a and DF-b groups compared with control, whereas circulating adiponectin concentration was increased in DF-a and DF-b groups compared with control. 3. Consistent with their effects on body weight gain and fat mass, circulating concentrations of triglyceride, glucose and insulin were decreased in DF-a and DF-b groups compared with control. 4. The size of adipocytes were decreased by DF-a and DF-b compared with control, whereas the adipocyte number per unit area was increased by them, suggesting that DF-a and DF-b decreased the number of large adipocytes. 5. Consistent with their effects on body weight gain, liver fibrosis was reduced in DF-a and DF-b groups compared with control. Conclusions : In conclusion, these results suggest that DF-a and DF-b not only decrease feeding efficiency ratio, plasma leptin concentration, and blood anti-obesity biomarkers, but also reduce fat mass, contributing to the improvement of obesity. DF-a and DF-b also inhibit liver fibrosis. In addition, these effects were similar between Pakistani Ephedra herba and Chinese Ephedra herba-containing Gangjihwan.

Feasibility and Efficacy of Adaptive Intensity Modulated Radiotherapy Planning according to Tumor Volume Change in Early Stage Non-small Cell Lung Cancer with Stereotactic Body Radiotherapy (폐암의 정위적체부방사선치료에서 육안적종양체적 변화에 따른 적응방사선치료의 효용성 및 가능성 연구)

  • Park, Jae Won;Kang, Min Kyu;Yea, Ji Woon
    • Progress in Medical Physics
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    • v.26 no.2
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    • pp.79-86
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    • 2015
  • The purpose of this study is to evaluate efficacy and feasibility of adaptive radiotherapy according to tumor volume change (TVC) in early stage non-small cell lung cancer (NSCLC) using stereotactic body radiotherapy (SBRT). Twenty-two lesions previously treated with SBRT were selected. SBRT was usually performed with a total dose of 48 Gy or 60 Gy in four fractions with an interval of three to four days between treatments. For evaluation of TVC, gross tumor volume (GTV) was contoured on each cone-beam computed tomography (CBCT) image used for image guidance. Intensity modulated radiotherapy (IMRT) planning was performed in the first CBCT (CBCT1) using a baseline plan. For ART planning (ART), re-optimization was performed at $2^{nd}$, $3^{rd}$, and $4^{th}$ CBCTs (CBCT2, CBCT3, and CBCT4) using the same angle and constraint used for the baseline plan. The ART plan was compared with the non-ART plan, which generated copying of the baseline plan to other CBCTs. Average GTV volume was 10.7 cc. Average TVC was -1.5%, 7.3%, and -25.1% in CBCT2, CBCT3, and CBCT4 and the TVC after CBCT3 was significant (p<0.05). However, the nine lesions were increased GTV in CBCT2. In the ART plan, $V_{20\;Gy}$, $D_{1500\;cc}$, and $D_{1000\;cc}$ of lung were significantly decreased (p<0.05), and $V_{30\;Gy}$ and $V_{32\;Gy}$ of the chest wall were also decreased (p<0.05). While D min of planning target volume (PTV) decreased by 8.3% in the non-ART plan of CBCT2 compared with the baseline plan in lesions with increased tumor size (p=0.021), PTV coverage was not compromised in the ART plan. Based on this result, use of the ART plan may improve target coverage and OAR saving. Thus ART using CBCT should be considered in early stage NSCLC with SBRT.

Dosimetric Verifications of the Output Factors in the Small Field Less Than $3cm^2$ Using the Gafchromic EBT2 Films and the Various Detectors (Gafchromic EBT2필름과 다양한 검출기를 이용하여 $3cm^2$ 이하의 소조사면에서 출력비율의 선량검증)

  • Oh, Se An;Yea, Ji Woon;Lee, Rena;Park, Heon Bo;Kim, Sung Kyu
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.218-224
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    • 2014
  • The small field dosimetry is very important in modern radiotherapy because it has been frequently used to treat the tumor with high dose hypo-fractionated radiotherapy or high dose single fraction stereotactic radiosurgery (SRS) with small size target. But, the dosimetry of a small field (< $3{\times}3cm^2$) has been great challenges in radiotherapy. Small field dosimetry is difficult because of (a) a lack of lateral electronic equilibrium, (b) steep dose gradients, and (c) partial blocking of the source. The objectives of this study were to measure and verify with the various detectors the output factors in a small field (<3 cm) for the 6 MV photon beams. Output factors were measured using the CC13, CC01, EDGE detector, thermoluminescence dosimeters (TLDs), and Gafchromic EBT2 films at the sizes of field such as $0.5{\times}0.5$, $1{\times}1$, $2{\times}2$, $3{\times}3$, $5{\times}5$, and $10{\times}10cm^2$. The differences in the output factors with the various detectors increased with decreasing field size. Our study demonstrates that the dosimetry for a small photon beam (< $3{\times}3cm^2$) should use CC01 or EDGE detectors with a small active volume. And also, Output factors with the EDGE detectors in a small field (< $3{\times}3cm^2$) coincided well with the Gafchromic EBT2 films.

The Effect of Gd-EOB-DPTA on the Stiffness Value of Magnetic Resonance Elastography in Evaluating Hepatic Fibrosis (간 섬유화 평가를 위한 MR elastography의 경직도에 대한 Gd-EOB-DTPA의 영향)

  • Lee, Jeong Eun;Lee, Jeong Min;Lee, Ye Ji;Yoon, Jeong-Hee;Lee, Kyung Bun;Han, Joon Koo;Choi, Byung Ihn
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.215-223
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    • 2013
  • Purpose : To evaluate the effect of gadoxetic acid on the measurement of the stiffness value of MR elastography (MRE) used to evaluate hepatic fibrosis (HF). Materials and Methods: MRE was obtained in 32 patients with clinically suspected chronic liver disease, both before and after injection of gadoxetic acid. Two independent reviewers measured the stiffness values of the liver parenchyma on elastograms. The mean liver stiffness values were compared in the pre- and post-contrast MREs using the paired t-test. Intra-rater and inter-rater correlation was assessed using the intraclass correlation coefficient (ICC). The accuracy, sensitivity, and specificity of both pre- and post-contrast MREs was evaluated for the diagnosis of significant HF (${\geq}F2$) using cut off value of 3.1 kPa. Results: There were no significant differences in the stiffness values of the liver parenchyma on pre- and post-contrast MREs (p = 0.15 and 0.38 for each reader, respectively). Regarding intra-rater correlation, excellent agreement was noted on rater 1(ICC = 0.998) and rater 2 (ICC = 0.996). Excellent correlation regarding the measured stiffness values was noted on both pre- and post-contrast MREs (ICC = 0.988 for pre-contrast, ICC = 0.993 for post-contrast). The accuracy, sensitivity, and specificity of the pre- and post-contrast MREs for differentiating significant HF (${\geq}F2$) from ${\geq}F1$ were same as 71%, 60%, and 100%, respectively. Conclusion: As there was no significant difference in the stiffness measurements seen on MREs before and after administration of gadoxetic acids, it is therefore acceptable to perform MRE after contrast injection in order to evaluate HF.