• Radiation Oncology Journal
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• v.25 no.4
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• pp.261-267
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• 2007

Purpose: To evaluate the association between radiation pneumonitis and dose-volume histogram parameters and to provide practical guidelines to prevent radiation pneumonitis following radiotherapy administered for breast cancer including internal mammary lymph nodes. Materials and Methods: Twenty patients with early breast cancer who underwent a partial mastectomy were involved in this study. The entire breast, supraclavicular lymph nodes, and internal mammary lymph nodes were irradiated with a dose of 50.4 Gy in 28 fractions. Radiation pneumonitis was assessed by both radiological pulmonary change (RPC) and by evaluation of symptomatic radiation pneumonitis. Dose-volume histogram parameters were compared between patients with grade <2 RPC and those with grade ${\geq}$2 RPC. The parameters were the mean lung dose, V10 (percent lung volume receiving equal to and more than 10 Gy), V20, V30, V40, and normal tissue complication probability (NTCP). Results: Of the 20 patients, 9 (45%) developed grade 2 RPC and 11 (55%) did not develop RPC (grade 0). Only one patient developed grade 1 symptomatic radiation pneumonitis. Univariate analysis showed that among the dose-volume histogram parameters, NTCP was significantly different between the two RPC grade groups (p<0.05). Fisher's exact test indicated that an NTCP value of 45% was appropriate as an RPC threshold level. Conclusion: This study shows that NTCP can be used as a predictor of RPC after radiotherapy of the internal mammary lymph nodes in breast cancer. Clinically, it indicates that an RPC is likely to develop when the NTCP is greater than 45%.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.261-266
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• 2003

Background: Surgery of abdominal aortic aneurysm revealed high operative mortality. We reviewed our 11-years' experiences of abdominal aortic aneurysm operation and wish to obtain information on the treatment. Material and Method: From Jan. 1990 to Dec. 2000, 48 patients were operated due to abdominal aortic aneurysm in Yonsei Cardiovascular Center Mean age was $62.8{\pm}12.7$ and there were 40 males and 8 females. Among 48 patients, nine patients had ruptured abdominal aortic aneurysm, and mean aneurysm diameter of non-ruptured cases was $8.8{\pm}2.4$cm. Result: There were 6 early deaths, and early mortality was 12.5%. Among 9 patients of preoperative aneurysm rupture, three patients died (33.3%), and among 39 patients of non-ruptured cases, 3 patients died (7.7%). Among preoperative variables, age (p<0.05), preoperative BUN level (p<0.05), and DM (p<0.05) were risk factors of early mortality. Among discharged 42 patients, 40 patients were followed up (f/u rate=95.2%) and mean follow up was $3.6{\pm}0.2$ years. During follow up periods, five patients died (late mortality=11.9%), and Kaplan-Meier survival analysis revealed $81.7{\pm}7.6$% survival rate at five and ten year. Linealized incidence of graft related event was 3.53% per patient-year. Conclusion: Surgical mortality of ruptured abdominal aortic aneurysm was higher than non-ruptured cases; therefore, early resection of the aneurysm can decrease the surgical mortality.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.35 no.2
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• pp.87-97
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• 2017

Paulownia species has long been recognized in Korean traditional culture and the values of the species have been researched in various focuses. However, studies on distribution and ecological characteristics of the species are still needed. This study aimed to identify distribution trends and ecological characteristics of two Paulownia species in Busan metropolitan city using the MaxEnt model. The MaxEnt model was established based on the environmental factors such as positioning information of the Paulownia species, topography, climate and degree of anthropogenic disturbance potentiality (ADP), which was collected in the on-site research. The study verified that the accuracy of the model was appropriate as the AUC value of Paulownia coreana and P. tomentosa was 0.809, respectively. In terms of the distribution trends of the two Paulownia species in the research area depending on the distribution model, they were both mainly distributed in downtown where built-up area and bare ground were densely concentrated. The potential distribution area of the two species was identified as $137.4km^2$ for P. coreana and $135.0km^2$ for P. tomentosa. The distribution probability was high in Jung-gu, Dongrae-gu, Busanjin-gu and Yeonje-gu. As a result of the analysis on contribution of the environmental factors, it was turned out that the degree of anthropogenic disturbance potentiality (ADP) contributed to distribution of P. coreana and P. tomentosa by about 50%, and the contribution of the environmental factors had a positive correlation with the degree of ADP. The elevation had a negative correlation with both the two species, which was considered because the species must compete more with native species in natural habitats as the altitude above sea level rises. The research findings demonstrated numerically that the distribution of P.coreana and P. tomentosa depended on artificial activities, and indicated the relevance with the Korean traditional landscape. These findings are expected to provide meaningful information in using, preserving and restoring Paulownia species.

• Journal of Radiation Protection and Research
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• v.40 no.4
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• pp.252-260
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• 2015

This paper describes the technical background for the Korean wildlife radiation dose assessment code, K-BIOTA, and the summary of its application. The K-BIOTA applies the graded approaches of 3 levels including the screening assessment (Level 1 & 2), and the detailed assessment based on the site specific data (Level 3). The screening level assessment is a preliminary step to determine whether the detailed assessment is needed, and calculates the dose rate for the grouped organisms, rather than an individual biota. In the Level 1 assessment, the risk quotient (RQ) is calculated by comparing the actual media concentration with the environmental media concentration limit (EMCL) derived from a bench-mark screening reference dose rate. If RQ for the Level 1 assessment is less than 1, it can be determined that the ecosystem would maintain its integrity, and the assessment is terminated. If the RQ is greater than 1, the Level 2 assessment, which calculates RQ using the average value of the concentration ratio (CR) and equilibrium distribution coefficient (Kd) for the grouped organisms, is carried out for the more realistic assessment. Thus, the Level 2 assessment is less conservative than the Level 1 assessment. If RQ for the Level 2 assessment is less than 1, it can be determined that the ecosystem would maintain its integrity, and the assessment is terminated. If the RQ is greater than 1, the Level 3 assessment is performed for the detailed assessment. In the Level 3 assessment, the radiation dose for the representative organism of a site is calculated by using the site specific data of occupancy factor, CR and Kd. In addition, the K-BIOTA allows the uncertainty analysis of the dose rate on CR, Kd and environmental medium concentration among input parameters optionally in the Level 3 assessment. The four probability density functions of normal, lognormal, uniform and exponential distribution can be applied.The applicability of the code was tested through the participation of IAEA EMRAS II (Environmental Modeling for Radiation Safety) for the comparison study of environmental models comparison, and as the result, it was proved that the K-BIOTA would be very useful to assess the radiation risk of the wildlife living in the various contaminated environment.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.517-529
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• 1998

Purpose : Although many studies have investigated the dosimetric aspects of stereotactic radiosurgery in terms of target volume, the absorbed doses at extracranial sites: especially the lens or thyroid - which are sensitive to radiation for deterministic or stochastic effect -have infrequently been reported. The aim of this study is to evaluate what effects the parameters of radiosurgery have on the absorbed doses of the lens and thyroid in patients treated by stereotactic radiosurgery, using a systematic plan in a humanoid phantom. Materials and Methods : Six isocenters were selected and radiosurgery was planned using the stereotactic radiosurgery system which the Department of Therapeutic Radiology at Seoul National University College of Medicine developed. The experimental radiosurgery plan consisted of 6 arc planes per one isocenter, 100 degrees for each arc range and an accessory collimator diameter size of 2 cm. After 250 cGy of irradiation from each arc, the doses absorbed at the lens and thyroid were measured by thermoluminescence dosimetry. Results : The lens dose was 0.23$\pm$0.08$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the lens and was 0.76$\pm$0.12$\%$ of the maximum dose for each isocenter when the exit beam passed through the lens. The thyroid dose was 0.18$\pm$0.05$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the thyroid and was 0.41$\pm$0.04$\%$ of the maximum dose for each isocenter when the exit beam Passed through the thyroid. The passing of the exit beam is the most significant factor of organ dose and the absorbed dose by an arc crossing organ decides 80$\%$ of the total dose. The absorbed doses of the lens and thyroid were larger as the isocenter sites and arc planes were closer to each organ. There were no differences in the doses at the surface and 5 mm depth from the surface in the eyelid and thyroid areas. Conclusion : As the isocenter and arc plane were placed closer to the lens and thyroid, the doses increased. Whether the exit beams passed through the lens or thyroid greatly influenced the lens and thyroid dose. The surface dose of the lens and thyroid consistently represent the tissue dose. Even when the exit beam passes through the lens and thyroid, the doses are less than 1$\%$ of the maximum dose and therefore, are too low to evoke late complications, but nevertheless, we should try to minimize the thyroid dose in children, whenever possible.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.265-274
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• 1998

Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.219-228
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• 2003

Purpose: The amount of salvaged myocardium is an important prognostic factor in patients with acute myocardial infarction (MI). We investigated if early Tl-201 SPECT imaging could be used to predict the salvaged myocardium and functional recovery in acute MI after primary PTCA. Materials and Methods: In 36 patients with first acute MI treated with primary PTCA, serial echocardiography and Tl-201 SPECT imaging ($5.8{\pm}2.1$ days after PTDA) were performed. Regional wall motion and perfusion were quantified with on 16-segment myocardial model with 5-point and 4-point scaling system, respectively. Results: Wall motion was improved in 78 of the 212 dyssynergic segments on 1 month follow-up echocardiography and 97 on 7 months follow-up echocardiography, which were proved to be salvaged myocardium. The areas under receiver operating characteristic curves of Tl-201 perfusion score for detecting salvaged myocardial segments were 0.79 for 1 month follow-up and 0.83 for 7 months follow-up. The sensitivity and specificity of Tl-201 redistribution images with optimum cutoff of 40% of peak thallium activity for detecting salvaged myocardium were 84.6% and 55.2% for 1 month follow-up, and 87.6% and 64.3% for 7 months follow-up, respectively. There was a linear relationship between the percentage of peak thallium activity on early redistribution imaging and the likelihood of segmental functional improvement 7 months after reperfusion. Conclusion: Tl-201 myocardial perfusion SPECT imaging performed early within 10 days after reperfusion can be used to predict the salvaged myocardium and functional recovery with high sensitivity during the 7 months following primary PTCA in patients with acute MI.