• Radiation Oncology Journal
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• v.22 no.4
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• pp.237-246
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• 2004

Purpose: To investigate the effects of radiation dose-escalation on the treatment outcome, complications and the other prognostic variables for glioblastoma patients treated with 3D-conformal radiotherapy (3D-CRT). Materials and Methods: Between Jan 1997 and July 2002, a total of 75 patients with histologically proven diagnosis of glioblastoma were analyzed. The patients who had a Karnofsky Performance Score (KPS) of 60 or higher, and received at least 50 Gy of radiation to the tumor bed were eligible. All the patients were divided into two arms; Arm 1, the high-dose group was enrolled prospectively, and Arm 2, the low-dose group served as a retrospective control. Arm 1 patients received $63\~70$ Gy (Median 66 Gy, fraction size $1.8\~2$ Gy) with 3D-conformal radiotherapy, and Arm 2 received 59.4 Gy or less (Median 59.4 Gy, fraction size 1.8 Gy) with 2D-conventional radiotherapy. The Gross Tumor Volume (GTV) was defined by the surgical margin and the residual gross tumor on a contrast enhanced MRI. Surrounding edema was not included in the Clinical Target Volume (CTV) in Arm 1, so as to reduce the risk of late radiation associated complications; whereas as in Arm 2 it was included. The overall survival and progression free survival times were calculated from the date of surgery using the Kaplan-Meier method. The time to progression was measured with serial neurologic examinations and MRI or CT scans after RT completion. Acute and late toxicities were evaluated using the Radiation Therapy Oncology Group neurotoxicity scores. Results: During the relatively short follow up period of 14 months, the median overall survival and progression free survival times were $15{\pm}1.65$ and $11{\pm}0.95$ months, respectively. The was a significantly longer survival time for the Arm 1 patients compared to those in Arm 2 (p=0.028). For Arm 1 patients, the median survival and progression free survival times were $21{\pm}5.03$ and $12{\pm}1.59$ months, respectively, while for Arm 2 patients they were $14{\pm}0.94$ and $10{\pm}1.63$ months, respectively. Especially in terms of the 2-year survival rate, the high-dose group showed a much better survival time than the low-dose group; $44.7\%$ versus $19.2\%$. Upon univariate analyses, age, performance status, location of tumor, extent of surgery, tumor volume and radiation dose group were significant factors for survival. Multivariate analyses confirmed that the impact of radiation dose on survival was independent of age, performance status, extent of surgery and target volume. During the follow-up period, complications related directly with radiation, such as radionecrosis, has not been identified. Conclusion: Using 3D-conformal radiotherapy, which is able to reduce the radiation dose to normal tissues compared to 2D-conventional treatment, up to 70 Gy of radiation could be delivered to the GTV without significant toxicity. As an approach to intensify local treatment, the radiation dose escalation through 3D-CRT can be expected to increase the overall and progression free survival times for patients with glioblastomas.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.118-126
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• 2001

Purpose : In this study, it was investigated whether dose response relation existed or not in local radiotherapy for primary hepatocellular carcinoma. Materials and Methods : From January 1992 to March 2000, 158 patients were included in present study. Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two thirds of the entire liver, and performance status on the ECOG scale of more than 3. Radiotherapy was given to the field including tumor with generous margin using 6, 10-MV X-ray. Mean tumor dose was $48.2{\pm}7.9\;Gy$ in daily 1.8 Gy fractions. Tumor response was based on diagnostic radiologic examinations such as CT scan, MR imaging, hepatic artery angiography at $4\~8$ weeks following completion of treatment. Statistical analysis was done to investigate the existence of dose response relationship of local radiotherapy when it was applied to the treatment of primary hepatocellular carcinoma. Results : An objective response was observed in 106 of 158 patients, giving a response rate of $67.1\%$. Statistical analysis revealed that total dose was the most significant factor in relation to tumor response when local radiotherapy was applied to the treatment of primary hepatocellular carcinoma. Only $29.2\%$ showed objective response in patients treated with dose less than 40 Gy, while $68.6\%\;and\;77.1\%$ showed major response in patients with $40\~50\;Gy$ and more than 50 Gy, respectively. Child-Pugh classification was significant factor in the development of ascites, overt radiation induced liver disease and gastroenteritis. Radiation dose was an important factor for development of radiation induced gastroduodenal ulcer. Conclusion : Present study showed the existence of dose response relationship in local radiotherapy for primary hepatocellular carcinoma. Only radiotherapy dose was a significant factor to predict the objective response. Further study is required to predict the maximal tolerance dose in consideration of liver function and non-irradiated liver volume.

• Progress in Medical Physics
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• v.23 no.1
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• pp.15-25
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• 2012

The aim of this study is to evaluate plan quality and dose accuracy for Volumetric Modulated Arc Therapy (VMAT) on the TG-119 and is to investigate the effects on variation of the selectable optimization parameters of VMAT. VMAT treatment planning was implemented on a Varian iX linear accelerator with ARIA record and verify system (Varian Mecical System Palo Alto, CA) and Oncentra MasterPlan treatment planning system (Nucletron BV, Veenendaal, Netherlands). Plan quality and dosimetric accuracy were evaluated by effect of varying a number of arc, gantry spacing and delivery time for the test geometries provided in TG-119. Plan quality for the target and OAR was evaluated by the mean value and the standard deviation of the Dose Volume Histograms (DVHs). The ionization chamber and $Delta^{4PT}$ bi-planar diode array were used for the dose evaluation. For treatment planning evaluation, all structure sets closed to the goals in the case of single arc, except for the C-shape (hard), and all structure sets achieved the goals in the case of dual arc, except for C-shape (hard). For the variation of a number of arc, the simple structure such as a prostate did not have the difference between single arc and dual arc, whereas the complex structure such as a head and neck showed a superior result in the case of dual arc. The dose distribution with gantry spacing of $4^{\circ}$ was shown better plan quality than the gantry spacing of $6^{\circ}$, but was similar results compared with gantry spacing of $2^{\circ}$. For the verification of dose accuracy with single arc and dual arc, the mean value of a relative error between measured and calculated value were within 3% and 4% for point dose and confidence limit values, respectively. For the verification on dose accuracy with the gantry intervals of $2^{\circ}$, $4^{\circ}$ and $6^{\circ}$, the mean values of relative error were within 3% and 5% for point dose and confidence limit values, respectively. In the verification of dose distribution with $Delta^{4PT}$ bi-planar diode array, gamma passing rate was $98.72{\pm}1.52%$ and $98.3{\pm}1.5%$ for single arc and dual arc, respectively. The confidence limit values were within 4%. The smaller the gantry spacing, the more accuracy results were shown. In this study, we performed the VMAT QA based on TG-119 procedure, and demonstrated that all structure sets were satisfied with acceptance criteria. And also, the results for the selective optimization variables informed the importance of selection for the suitable variables according to the clinical cases.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.5
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• pp.263-270
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• 2006

Purpose: Several radioisotope-labeled thymidine derivatives such as $[^{11}C]$thymidine was developed to demonstrate cell proliferation in tumor. But it is difficult to track metabolism with $[^{11}C]$thymidine due to rapid in vivo degradation and its short physical half-life. 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) was reported to have the longer half life of fluorine-18 and the lack of metabolic degradation in vivo. Here, we described the synthesis of the 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) and compared with $([^{18}F]FET)\;and\;([^{18}F]FDG)$ in cultured 9L cell and obtained the biodistribution and PET image in 9L tumor hearing rats. Material and Methods: For the synthesis of $[^{18}F]$FLT, 3-N-tert-butoxycarbonyl-(5'-O-(4,4'-dimet hoxytriphenylmethyl)-2'-deoxy-3'-O-(4-nitrobenzenesulfonyl)-${\beta}$-D-threopentofuranosyl)thymine was used as a FLT precursor, on which the tert-butyloxycarbonyl group was introduced to protect N3-position and nitrobenzenesulfonyl group. Radiolabeling of nosyl substitued precursor with $^{18}F$ was performed in acetonitrile at $120^{\circ}C$ and deproteced with 0.5 N HCI. The cell uptake was measured in cultured 9L glioma cell. The biodistribution was evaluated in 9L tumor bearing rats after intravenous injection at 10 min, 30 min, 60 min and 120 min and obtained PET image 60 minutes after injection. Results: The radiochemical yield was about 20-30% and radiochemical purity was more than 95% after HPLC purification. Cellular uptake of $[^{18}F]$FLT was increased as time elapsed. At 120 min post-injection, the ratios of tumor/blood, tumor/muscle and tumor/brain were $1.61{\pm}0.34,\;1.70{\pm}0.30\;and\;9.33{\pm}2.22$, respectively. The 9L tumor was well visualized at 60 min post injection in PET image. Conclusion: The uptake of $[^{18}F]$FLT in tumor was higher than in normal brain and PET image of $[^{18}F]$FLT was acceptable. These results suggest the possibility of $[^{18}F]$FLT at an imaging agent for brain tumor.

• Progress in Medical Physics
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• v.18 no.2
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• pp.81-86
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• 2007

The cone-beam CT (CBCT) which is acquired using on-board imager (OBI) attached to a linear accelerator is widely used for the image guided radiation therapy. In this study, the effect of respiratory motion on the quality of CBCT image was evaluated. A phantom system was constructed in order to simulate respiratory motion. One part of the system is composed of a moving plate and a motor driving component which can control the motional cycle and motional range. The other part is solid water phantom containing a small cubic phantom ($2{\times}2{\times}2cm^3$) surrounded by air which simulate a small tumor volume in the lung air cavity CBCT images of the phantom were acquired in 20 different cases and compared with the image in the static status. The 20 different cases are constituted with 4 different motional ranges (0.7 cm, 1.6 cm, 2.4 cm, 3.1 cm) and 5 different motional cycles (2, 3, 4, 5, 6 sec). The difference of CT number in the coronal image was evaluated as a deformation degree of image quality. The relative average pixel intensity values as a compared CT number of static CBCT image were 71.07% at 0.7 cm motional range, 48.88% at 1.6 cm motional range, 30.60% at 2.4 cm motional range, 17.38% at 3.1 cm motional range The tumor phantom sizes which were defined as the length with different CT number compared with air were increased as the increase of motional range (2.1 cm: no motion, 2.66 cm: 0.7 cm motion, 3.06 cm: 1.6 cm motion, 3.62 cm: 2.4 cm motion, 4.04 cm: 3.1 cm motion). This study shows that respiratory motion in the region of inhomogeneous structures can degrade the image quality of CBCT and it must be considered in the process of setup error correction using CBCT images.

• Progress in Medical Physics
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• v.22 no.1
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• pp.42-51
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• 2011

Nuclear medicine images (SPECT, PET) were widely used tool for assessment of myocardial viability and perfusion. However it had difficult to define accurate myocardial infarct region. The purpose of this study was to investigate methodological approach for automatic measurement of rat myocardial infarct size using polar map with adaptive threshold. Rat myocardial infarction model was induced by ligation of the left circumflex artery. PET images were obtained after intravenous injection of 37 MBq $^{18}F$-FDG. After 60 min uptake, each animal was scanned for 20 min with ECG gating. PET data were reconstructed using ordered subset expectation maximization (OSEM) 2D. To automatically make the myocardial contour and generate polar map, we used QGS software (Cedars-Sinai Medical Center). The reference infarct size was defined by infarction area percentage of the total left myocardium using TTC staining. We used three threshold methods (predefined threshold, Otsu and Multi Gaussian mixture model; MGMM). Predefined threshold method was commonly used in other studies. We applied threshold value form 10% to 90% in step of 10%. Otsu algorithm calculated threshold with the maximum between class variance. MGMM method estimated the distribution of image intensity using multiple Gaussian mixture models (MGMM2, ${\cdots}$ MGMM5) and calculated adaptive threshold. The infarct size in polar map was calculated as the percentage of lower threshold area in polar map from the total polar map area. The measured infarct size using different threshold methods was evaluated by comparison with reference infarct size. The mean difference between with polar map defect size by predefined thresholds (20%, 30%, and 40%) and reference infarct size were $7.04{\pm}3.44%$, $3.87{\pm}2.09%$ and $2.15{\pm}2.07%$, respectively. Otsu verse reference infarct size was $3.56{\pm}4.16%$. MGMM methods verse reference infarct size was $2.29{\pm}1.94%$. The predefined threshold (30%) showed the smallest mean difference with reference infarct size. However, MGMM was more accurate than predefined threshold in under 10% reference infarct size case (MGMM: 0.006%, predefined threshold: 0.59%). In this study, we was to evaluate myocardial infarct size in polar map using multiple Gaussian mixture model. MGMM method was provide adaptive threshold in each subject and will be a useful for automatic measurement of infarct size.

• Korean Journal of Hospice Care
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• v.7 no.1
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• pp.5-14
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• 2007

Objective : This study was done to identify the status of Spiritual Well-Being in Nursing Students and to investigate the correlation between related various characteristics and Spiritual Well-Being and to provide baseline data for ride school-life and development of Spiritual-education program for nursing students. Method : The data was collected from 188 christian Nursing students by using questionary method. they are all all agreed to participate in this study. Their Spiritual Well-Being were measured using Spiritual Well-Being scale developed by Paloutzian & Ellison(1983) and translated by Choi(1990) and reversed by Kang(1996). Results : The data was analyzed by using SPSS/PC+12.0. The summary of results were as follows; 1. The mean score of Spiritual Well-Being were $63.95\pm10.256$(range from 20-80) 2. There were significant differences between the grade(F=6.101, p= .001), type of religion(F= 17.703, p= .000), In Christian, the level of devotee(F=8.194, p= .000), duration of church attendance(F=7.947, p= .000), regular attendance of chapel(F=4.242, p= .000), regular reading(study) of Bible and prayer (F=5.863, p= .001=0). perceived personal encounter with Jesus(F=4.160, p= .000), religion of parent(F=9.320, p= .000), perceived attitude of parenting(F=4.146, p= .000), hope to admit/transfer to other course or not(F=-2.050, p= .050). Conclusion : Our results were valuable to provide basic guidelines for ride school-life and for the development of Spiritual-education program for Nursing students.

• 한국유가공학회:학술대회논문집
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• 2007.09a
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• pp.49-58
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• 2007

Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

• Journal of Intelligence and Information Systems
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• v.20 no.3
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• pp.109-131
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• 2014

As the demand of nuclear power plant equipment is continuously growing worldwide, the importance of handling nuclear strategic materials is also increasing. While the number of cases submitted for the exports of nuclear-power commodity and technology is dramatically increasing, preadjudication (or prescreening to be simple) of strategic materials has been done so far by experts of a long-time experience and extensive field knowledge. However, there is severe shortage of experts in this domain, not to mention that it takes a long time to develop an expert. Because human experts must manually evaluate all the documents submitted for export permission, the current practice of nuclear material export is neither time-efficient nor cost-effective. Toward alleviating the problem of relying on costly human experts only, our research proposes a new system designed to help field experts make their decisions more effectively and efficiently. The proposed system is built upon case-based reasoning, which in essence extracts key features from the existing cases, compares the features with the features of a new case, and derives a solution for the new case by referencing similar cases and their solutions. Our research proposes a framework of case-based reasoning system, designs a case-based reasoning system for the control of nuclear material exports, and evaluates the performance of alternative keyword extraction methods (full automatic, full manual, and semi-automatic). A keyword extraction method is an essential component of the case-based reasoning system as it is used to extract key features of the cases. The full automatic method was conducted using TF-IDF, which is a widely used de facto standard method for representative keyword extraction in text mining. TF (Term Frequency) is based on the frequency count of the term within a document, showing how important the term is within a document while IDF (Inverted Document Frequency) is based on the infrequency of the term within a document set, showing how uniquely the term represents the document. The results show that the semi-automatic approach, which is based on the collaboration of machine and human, is the most effective solution regardless of whether the human is a field expert or a student who majors in nuclear engineering. Moreover, we propose a new approach of computing nuclear document similarity along with a new framework of document analysis. The proposed algorithm of nuclear document similarity considers both document-to-document similarity (${\alpha}$) and document-to-nuclear system similarity (${\beta}$), in order to derive the final score (${\gamma}$) for the decision of whether the presented case is of strategic material or not. The final score (${\gamma}$) represents a document similarity between the past cases and the new case. The score is induced by not only exploiting conventional TF-IDF, but utilizing a nuclear system similarity score, which takes the context of nuclear system domain into account. Finally, the system retrieves top-3 documents stored in the case base that are considered as the most similar cases with regard to the new case, and provides them with the degree of credibility. With this final score and the credibility score, it becomes easier for a user to see which documents in the case base are more worthy of looking up so that the user can make a proper decision with relatively lower cost. The evaluation of the system has been conducted by developing a prototype and testing with field data. The system workflows and outcomes have been verified by the field experts. This research is expected to contribute the growth of knowledge service industry by proposing a new system that can effectively reduce the burden of relying on costly human experts for the export control of nuclear materials and that can be considered as a meaningful example of knowledge service application.

• Journal of Practical Agriculture & Fisheries Research
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• v.24 no.3
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• pp.15-24
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• 2022

In 2000, a total of 23,794ha of forest was lost due to the East Coast forest fire, and about 70% of the damaged area was concentrated in Samcheok. In 2001, artificial restoration and natural restoration were implemented in the damaged area. This study was conducted to understand the current vegetation structure 21 years after the restoration of forest fire damage in the Samcheok, Gumbong Mountain area. As a result of classifying the vegetation community, it was divided into three communities: Quercus variabilis-Pinus densiflora community, Pinus densiflora-Quercus mongolica community, and Pinus thunbergii community. Quercus variabilis, Pinus densiflora, and Pinus thunbergii planted in the artificial restoration site were found to continue to grow as dominant species in the local vegetation after restoration. As for the species diversity index of the community, the Quercus variabilis-Pinus densiflora community dominated by deciduous broad-leaf trees showed the highest, and the coniferous forest Pinus thunbergii community showed the lowest. Vegetation in areas affected by forest fires is greatly affected by reforestation tree species, and 21 years later, it has shown a tendency to recover to the forest type before forest fire. In order to establish DataBase for effective restoration and to prepare monitoring data, it is necessary to construct data through continuous vegetation survey on the areas affected by forest fires.