• Radiation Oncology Journal
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• v.21 no.3
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• pp.238-244
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• 2003

Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

• Journal of KIISE:Software and Applications
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• v.30 no.5_6
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• pp.444-453
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• 2003

Recently, a great interest of bio-technology(BT) is concentrated and the image analysis technique for electrophoresis gels is highly requested to analyze genetic information or to look for some new bio-activation materials. For this purpose, the location and quantity of each band in a lane should be measured. In most of existing techniques, the approach of peak searching in a profile of a lane is used. But this peak is improper as the representative of a band, because its location does not correspond to that of the brightest pixel or the center of gravity. Also, it is improper to measure band quantity in most of these approaches because various enhancement processes are commonly applied to original images to extract peaks easily. In this paper, we adopt an approach to measure accumulated brightness as a band quantity in each band region, which Is extracted by not using any process of changing relative brightness, and the gravity center of the region is calculated as a band location. Actually, we first extract lanes with an entropy-based threshold calculated on a gel-image histogram. And then, three other methods are proposed and applied to extract bands. In the MER method, peaks and valleys are searched on a vertical search line by which each lane is bisected. And the minimum enclosing rectangle of each band is set between successive two valleys. On the other hand, in the RG-1 method, each band is extracted by using region growing with a peak as a seed, separating overlapped neighbor bands. In the RG-2 method, peaks and valleys are searched on two vertical lines by which each lane is trisected, and the left and right peaks nay be paired up if they seem to belong to the same band, and then each band region is grown up with a peak or both peaks if exist. To compare above three methods, we have measured the location and amount of bands. As a result, the average errors in band location of MER, RG-1, and RG-2 were 6%, 3%, and 1%, respectively, when the lane length is normalized to a unit value. And the average errors in band amount were 8%, 5%, and 2%, respectively, when the sum of band amount is normalized to a unit value. In conclusion, RG-2 was shown to be more reliable in the accuracy of measuring the location and amount of bands.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.3
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• pp.226-233
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• 2007

Purpose: Dual reporter gene imaging has several advantages for more sophisticated molecular imaging studies such as gene therapy monitoring. Herein, we have constructed hepatoma cell line expressing dual reporter genes of sodium iodide symporter (NIS) and enhanced green fluorescence protein (EGFP), and the functionalities of the genes were evaluated in vivo by nuclear and optical imaging. Materials and Methods: A pRetro-PN vector was constructed after separating NIS gene from pcDNA-NIS. RSV-EGFP-WPRE fragment separated from pLNRGW was cloned into pRetro-PN vector. The final vector expressing dual reporter genes was named pRetro-PNRGW. A human hepatoma (HepG2) cells were transfected by the retrovirus containing NIS and EGFP gene (HepG2-NE). Expression of NIS gene was confirmed by RT-PCR, radioiodine uptake and efflux studies. Expression of EGFP was confirmed by RT-PCR and fluorescence microscope. The HepG2 and HepG2-NE cells were implanted in shoulder and hindlimb of nude mice, then fluorescence image, gamma camera image and I-124 microPET image were undertaken. Results: The HepG2-NE cell was successfully constructed. RT-PCR showed NIS and EGFP mRNA expression. About 50% of cells showed fluorescence. The iodine uptake of NIS-expressed cells was about 9 times higher than control. In efflux study, $T_{1/2}$ of HepG2-NE cells was 9 min. HepG2-NE xenograft showed high signal-to-background fluorescent spots and higher iodine-uptake compared to those of HepG2 xenograft. Conclusion: A hepatoma cell line expressing NIS and EGFP dual reporter genes was successfully constructed and could be used as a potential either by therapeutic gene or imaging reporter gene.

• Journal of Genetic Medicine
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• v.4 no.2
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• pp.186-189
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• 2007

More than 6,000 rare disorders including genetic diseases have been reported. Of them, 1,500 diseases (1,211 for clinical diagnosis and 289 for research only) are technically possible for genetic testing. In Korea, since 2005, only 63 genetic diseases is permitted for prenatal genetic testing by the "Bioethics and Biosafety Law". The article 25 in the law prescribes 63 genetic diseases without clear indication for its selection and inclusion criteria. In EU, USA, and other foreign countries, however, there is no provision in the statute on prenatal genetic testing; it is not restricted by a law. Recently, a woman (Mrs. L, 38y) who is a carrier for Menkes disease made an appeal to a government for an amendment of the "Bioethics and Biosafety Law" prohibiting the prenatal diagnosis of her pregnancy at risk for Menkes disease. Menkes disease (MNK) is an X-linked recessive disorder characterized by neurodegeneration, connective tissue defects and hair abnormalities, and no effective treatment is available yet. The prevalence rate of MNK is one in about 250,000 live births. Menkes syndrome patients fail to absorb copper from the gastrointestinal tract in quantities adequate for meeting nutritional needs. These needs seem particularly acute during the initial 12 month of life, when the velocity of brain growth and motor neurodevelopment. Most of pts. die around 3yrs. of age. Mrs. L had a boy with Menkes disease who died at 2y.o. in 2001. Subsequent pregnancy in 2003, she was able to have prenatal genetic testing for mutation of the Menkes (ATP7A) gene and delivered a healthy baby boy. Now, She is pregnant again and wants to have prenatal diagnosis. however, this time, she was not allowed to have any more because Menkes disease is not included in 63 genetic diseases permitted by the law for prenatal genetic testing, in spite of the fact that she is a Menkes disease carrier and her pregnancy is at risk to have an affected baby. This case shows the practical problem of the legal restriction for prenatal genetic testing in Korea. In this study, we report a arguable case and discuss the controversial issues in the legal restriction for prenatal genetic testing in Korea.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.112-117
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• 2008

Purpose: This study prospectively evaluated the outcome of arthroscopic transtendinous repair as a treatment for partial articular side tears of the rotator cuff. Materials and Methods: Fifteen patients with symptomatic, partial articular side tears of the rotator cuff underwent modified transtendinous repair. The patient's mean age was 52.5 years and the mean duration of symptoms was 33.7 weeks. The visual analogue scale (VAS), the ASES score, the active ROM of the shoulder and the patient's satisfaction were evaluated both preoperatively and postoperatively. The clinical results were analyzed using the Wilcoxon's signed rank test. Results: The mean VAS was $6.6\pm1.1$ before treatment and $0.4\pm0.6$ at 6 month, and the ASES scores for all the patients were significantly better over the six-month period of follow-up (p<0.05). The mean active ROM in abduction was $94.3\pm22.3$ before treatment, $108.7\pm16.3$ at 1 month (p=0.0041) and $164.3\pm5.3$ at six months (p=0.0006). In flexion, it was $105.0\pm23.8$ before treatment, $119.0\pm17.4$ at 1 month(p=0.0075) and $174.3\pm5.3$ at six months (p=0.0006). At the final follow-up, 94% of patients were satisfied or very satisfied after operation. Conclusion: We experienced satisfactory clinical results after a short-term follow-up of arthroscopic transtendinous repair, and we believed this to be an effective procedure for patients with partial articular side tears of the rotator cuff.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1070-1075
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• 1998

Background: With the advent of thoracoscopy, there has been increasing interest in less invasive surgical bullectomy and pleurodesis. The recurrence rate, however, has been reported higher in surgery with thoracoscopy than with open thoracotomy and it is thought to be caused by inappropriate mechanical pleurodesis during thoracoscopic surgery. Materials and methods: We compared the short-term recurrence rates according to the intensities of pleural abrasion in 62 patients who underwent VATS for treatment of spontaneous pneumothorax from April 1996 to August 1997. The patients were divided into 2 groups: group A(n=32) included patients who received relatively weak pleural abrasion using Endo-forcep instrument for grasping the gauze, and group B(n=30) received strong pleural abrasion using conventional instrument wrapped tightly with gauze. Each intensity of pleural abrasion allowed petechia on the parietal pleura in group A, and some tearing and bleeding in group B. Results: Indications for operation, sex distribution, and age were comparable in both groups. There were no differences in chest tube indwelling time(3.78±3.35 vs 3.80±2.49 days), hospital stay(4.72±1.87 vs 4.67±2.20 days), and the amount and duration of analgesics required postoperatively. Persistent air-leak more than 7 days after surgery occurred in 4/32(12.5%) and 2/30(6.7%) in group A and B, respectively. No bleeding-related complication occured. Pneumothorax recurred 12.5%(4/32) and 0%(0/30) of patients at a mean follow-up of 9.7 and 9.6 months in group A and B, respectively, and it was statistically significant(p<0.05). Conclusions: Proper intensity of pleural abrasion is very important factor to reduce recurrence after VATS for spontaneous pneumothorax. During short-term follow-upafter surgery, we could achieve excellent result in reducing recurrence rate with VATS and strong pleural abrasion which is comparable to thoracotomy.

• Journal of Nutrition and Health
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• v.9 no.4
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• pp.4-8
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• 1976

영양지도원(營養指導員)은 자신(自身)이 알고 있는 기술(技術)을 다른 사람에게 전달(傳達)하여 그 사람으로 하여금 지도원(指導員)이 원하는 방향(方向)으로 행동(行動)을 하도록 해야 한다. 따라서 다른 사람을 지도(指導)하려면은 우선 지도원 자신(指導員自身)의 우수한 자질(資質)"이 필요(必要) 하며 이를 위(爲)하여 기술자(技術者)로서의 연마(硏磨)와 겸(兼)하여 인간(人間)의 지도자(指導者)로서의 수양(修養)을 쌓아야 한다. 그리하여 영양개선(營養改善) 의 선도적(先導的) 점화자(點火者)로 "뒤에서 계속 미는" 지원자(支援者)로서의 역할(役割)을 수행(遂行)하여야 한다. (1) 현직능별(現職能別) 영양지도원(營養指導員)의 범위(範圍)를 보건소(保健所)의 보건지도원(保健指導員), 농촌지도소(農村指導所)의 생활지도요원(生活指導要員), 군면(郡面)의 행정지도요원(行政指導要員), 농협(農協)의 부여지도요원(婦女指導要員), 의료계(醫療界)의 의사(醫師), 간호원(看護員), 조산원(助産員), 학교(學校) 교육기관(敎育機關)의 교사(敎師), 영양사(營養士), 영리회사(營利會社)의 사원(社員) 등을 들 수 있다. (2) 지도대상(指導對象)과 그 장소(場所)는 공장(工場), 학교(學校), 훈련장(訓練場), 병원(病院), 복지시설(福祉施設)과 공동취사(共同炊事) 재해시등(災害時等)의 집단급식장(集團給食場)과 이를 이용(利用)하는 對象者(대상자) 도시(都市) 농촌(農村)의 일반가정(一般家庭)의 주민(住民), 그리고 교실(敎室)에서 학교교과목(學校敎科目)을 통(通)한 학생(學生)의 학습(學習) 새마을운동(運動) 공보시설(公報施設)을 통(通)하여 대중(大衆)에게 "지도(指導)를 지도원(指導員)이" 전개(展開)할 수 있다. (3) 지도방법(指導方法)은 일반적(一般的) 학교교육과정(學校敎育過程)의 교육방법(敎育方法)을 적용(適用)하되 교외교육(校外敎育)이라는 점(點)을 잊어서는 안된다. 현실적(現實的)으로 이론(理論)과 경험(經驗)을 병행활용(倂行活用)하며 영양학(營養學)의 연구결과(硏究結果)가 반드시 또 는 곧 가정생활(家庭生活) 개인생활(個人生活)에 적응(適應)되는 것이 아니며, 행동화(行動化)되지 않는 지식(知識)과 기술(技術)은 무용(無用)하게 되므로 "다고 말 할 수 있다. 따라서 영양개선(營養改善)을 지도(指導)하는 지도원(指導員)은 받아들이는 가정(家庭)이나 개인(個人)의 입장(立場)에서 여러 가지 여건을 파악 최대공약수(最大公約數)의 가능치(可能値)를 알아내서 지도(指導)해야 된다. (4) 영양지도(營養指導)는 기술(技術)이 ,포함(包含)되어 있기 때문에 기술(技術)의 전달과정(傳達過程)을 분석(分析)해야 되고 (5) 지도원(指導員) 자신의 무장(武裝)을 위(爲)하여 자신(自身)의 기술지도(技術指導) 방법(方法), 인간지도자(人間指導者)로서의 능력향상(能力向上)을 독서(讀書), 교육(敎育), 훈련(訓練) 을 통(通)하여 배워 기술자(技術者)로서 인간지도자(人間指導者)로서 전달자(傳達者)로 서의 교양(敎養)을 가져야 한다. (6) 지도원(指導員)의 활동성과(活動成果)는 지도원(指導員) 자신의 열의(熱意)와 받아들이는 사람의 열의(熱意)에 의(依)하여 좌우(左右)된다. 즉(卽) 지도원(指導員)의 열의(熱意)${\times}$피지도자(被指導者)의 열의(熱意)=지도성과(指導成果) $[L{\times}P=f(L{\cdot}P)]$로 나타난다. 결론적(結論的)으로 지도원(指導員)은 영양개선(營養改善)의 전문적(專門的) 각 요소(各要素)를 깊이 알고 이것을 다시 종합(綜合)하고 체계화(體系化)할 줄 알며 직능별(職能別) 각 지도원(各指導員)과의 상호(相互) 협조(協助)로 서로 보완(補完)하고 새마을 운동(運動)과 그 직장(職場) 또는 환경(環境)여건에 결부(結付)되고 현실적(現實的)으로 행동화(行動化)할 수 있는 단계적(的) 장단기계획(長短期計劃)과 평가방법(評價方法)을 숙지(熟知)하여 또 지도방법(指導方法)에 필요(必要)한 교재(敎材)를 충실(充實)히 준비하여 자신(自身)의 실력(實力)을 충분(充分)히 발휘할 수 있도록 하여 자기 열의(熱意)를 다하고" 영양개선(營養改善)의 선도적(先導的) 점화자(點火者)로서 "계속 뒤에서 미는" 지원자(支援者)로서 사명(使命)을 다할 때 그 역할(役割)을 다하는 것이다.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.33-38
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• 2009

Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1232-1238
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• 2005

Purpose : Though more than 15 years have passed after introduction of Lorenzo's oil therapy in X-linked adrenoleukodystrophy(ALD), its efficacy is still fully not known. In patients who already have neurologic symptoms, most reports indicate that the neurologic disability continues to increase. We evaluated its efficacy in X-linked ALD patients. Methods : Four patients who were treated with Lorenzo's oil for at least 12 months were enrolled from 1996 to 2003. During treatment, changes of neurologic symptoms, brain magnetic resonance imaging(MRI) findings, and serum saturated very long-chain fatty acid(C26:0) were assessed. Results : Two patients with childhood cerebral ALD had progression of neurologic symptoms and MRI lesions during treatment. One asymptomatic patient developed childhood cerebral ALD after six year treatment of Lorenzo's oil. One "Addison only" patient remained neurologically intact after three years. During Lorenzo's oil therapy, serum C26:0 levels which had increased at diagnosis decreased in all four patients. Conclusion : Treatment with Lorenzo's oil did not prevent disease progression in childhood cerebral ALD patients who were already symptomatic. Long term follow up will be needed in asymptomatic ALD including "Addison only" to reveal the efficacy of Lorenzo's oil.

• Clinical and Experimental Pediatrics
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• v.52 no.7
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• pp.798-803
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• 2009

Purpose : We aimed to examine the effectiveness of the head-up tilt test (HUT) for the diagnosis of syncope or presyncope in children and adolescents. Methods : HUT results and clinical features of 160 children and adolescents with syncope or presyncope were studied from May 2003 through March 2008 at the Chonbuk National University Hospital. The children and adolescents were subjected to $70^{\circ}$ HUT for 45 minutes. The testees were divided into 2 groups: group I (children) comprising 39 children in the age range 7-12 years (mean, $10.59{\pm}1.60$ years) and group II (adolescents) comprising 121 adolescents in the age range 13-20 years (mean, $15.93{\pm}2.28$ years). Positive result rates of the HUT and types of hemodynamic response to the test in the 2 groups were compared. Results : Of the 160 testees, 92 (57.5%) showed positive HUT results; they showed 3 patterns of response to tilting. Twelve patients showed a predominantly vasodepressor response; 10 patients showed a cardioinhibitory response; and 70 patients showed a mixed response. The positive result rates were 43.6% (17/39) and 62.0% (75/121) in groups I and II, respectively. Mixed response was the predominant positive hemodynamic response in both the groups. Conclusion : The HUT is a useful diagnostic tool for evaluating the condition of pediatric patients, including adolescents, with syncope. Further, it may be considered as the first step for evaluating the condition of such patients.