• The Journal of Korean Society for Radiation Therapy
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• v.10 no.1
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• pp.69-77
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• 1998

When a high energy photon beam is used to treat lesions located in the upper respiratory air passages or in maxillary sinus, the beams often must traverse an air cavity before it reaches the lesion. Because of this traversal of air, it is not clear that the surface layers of the lesion forming the air-tumor tissue interface will be in a state of near electronic equilibrium; if they are not, underdosing of these layers could result. Although dose corrections at large distances beyond an air cavity are accountable by attenuation differences, perturbations at air-tissue interfaces are complex to measure or calculate. This problem has been investigated for 4MV and 10MV X-ray beams which are becoming widely available for radiotherapy with linear accelerator. Markus chamber was used for measurement with variouse air cavity geometries in X-ray beams. Underdosing effects occur at both the distal and proximal air cavity interface. The magnitude depended on geometry, energy, field sizes and distance from the air-tissue interfaces. As the cavity thickness increased, the central axis dose at the distal interface decreased. Increasing field size remedied the underdosing, as did the introduction of lateral walls. Fellowing a $20{\times}2{\times}2\;cm^3$\;air\;cavity,\;4{\times}4\;cm\;field\;there\;was\;an\;11.5\%\;and\;13\%\;underdose\;at\;the\;distal\;interface,\;while\;a\;20{\times}20{\times}2\;cm^3\;air\;cavity\;yielded\;a\;24\%\;and\;29\%$ loss for the 4MV and 10MV beams, respectively. The losses were slightly larger for the 10MV beams. The measurements reported here can be used to guide the development of new calculation models under non-equilibrium conditions. This situation is of clinical concern when lesions such as larynx and maxillary carcinoma beyond air cavities are irradiated.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.397-402
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• 1995

Purpose : To determine the perturbation effect in the tissue downstream from surface layers of lesions located in the air/tumor-tissue interface of larynx using 6MV photon beam. Materials and Methods : Thermoluminescent dosimeters(TLDs), were embedded at 3 measurement locations in slab no. 7 of a humanoid phantom and exposed to forward and backward direction using various field sizes($4{\times}4cm^2\;-\;15{\times}15cm^2$). Results : At the air/tissue interface, forward dose perturbation factor(FDPF) is about 1.085 with $4{\times}4cm^2,\;1.05\;with\;7{\times}7cm^2,\;1.048\;with\;10{\times}10cm^2$ and $1.041\;with\;15{\times}15cm^2$. Backscatter dose perturbation factor(BDPF) is about 0.99 with $4{\times}4cm^2$, 0.981 with $7{\times}7cm^2$, 0.956 with $10{\times}10cm^2$ and 0.97 with $15{\times}15cm^2$. Conclusion : FDPF is greater as field size is smaller. And FDPF is smaller as the distance is further from the air/tissue interface.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.277-283
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• 1995

Purpose : This study was performed to measure dose alteration at the air-tissue interface resulting from rebuild-up to the loss of charged particle equilibrium in the tissues around the air-tissue interfaces. Materials and Methods : The 6 and 10-MV photon beam in dual energy linear accelerator were used to measure the surface dose at the air-tissue interface The polystyrene phantom sized $25{\times}25{\times}5\;cm^3$ and a water phantom sized $29{\times}29{\times}48\;cm^3$ which incorporates a parallel-plate ionization chamber in the distal side of air gap were used in this study. The treatment field sizes were $5{\times}5\;cm^2,\;10{\times}10\;cm^2\;and\;20{\times}20\;cm^2$. Air cavity thickness was variable from 10 mm to 50 mm. The observed-expected ratio (OER) was defined as the ratio of dose measured at the distal junction that is air-tissue interface to the dose measured at the same point in a homogeneous phantom. Results : In this experiment, the result of OER was close or slightly over than 1.0 for the large field size but much less (about 0.565) than 1.0 for the small field size in both photon energy. The factors to affect the dose distribution at the air-tissue interface were the field size, the thickness of air cavity. and the photon energy. Conclusion : Thus, the radiation oncologist should take into account dose reduction at the air-tissue interface when planning the head and neck cancer especially pharynx and laryngeal lesions, because the dose can be less nearly $29{\%}$ than predicted value.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.1-9
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• 2008

Purpose: For head and neck cancer patients treated with radiation therapy, proper immobilization of intra-oral structures is crucial in reproducing treatment positions and optimizing dose distribution. We produced a man-made tongue immobilization device for each patient subjected to this study. Reproducibility of treatment positions and dose distributions at air-and-tissue interface were compared using man-made tongue immobilization devices and conventional tongue-bites. Materials and Methods: Dental alginate and putty were used in producing man-made tongue immobilization devices. In order to evaluate reproducibility of treatment positions, all patients were CT-simulated, and linac-gram was repeated 5 times with each patient in the treatment position. An acrylic phantom was devised in order to evaluate safety of man-made tongue immobilization devices. Air, water, alginate and putty were placed in the phantom and dose distributions at air-and-tissue interface were calculated using Pinnacle (version 7.6c, Phillips, USA) and measured with EBT film. Two different field sizes (3$\times$3 cm and 5$\times$5 cm) were used for comparison. Results: Evaluation of linac grams showed reproducibility of a treatment position was 4 times more accurate with man-made tongue immobilization devices compared with conventional tongue bites. Patients felt more comfortable using customized tongue immobilization devices during radiation treatment. Air-and-tissue interface dose distributions calculated using Pinnacle were 7.78% and 0.56% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Dose distributions measured with EBT (international specialty products, USA) film were 36.5% and 11.8% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Values from EBT film were higher. Conclusion: Using man-made tongue immobilization devices made of dental alginate and putty in treatment of head and neck cancer patients showed higher reproducibility of treatment position compared with using conventional mouth pieces. Man-made immobilization devices can help optimizing air-and-tissue interface dose distributions and compensating limited accuracy of radiotherapy planning systems in calculating air-tissue interface dose distributions.

• Radiation Oncology Journal
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• v.7 no.1
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• pp.113-121
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• 1989

The inclusion of air filled cavities in treatment fields creates a potential dosimetric problem due to the rebuildup phenomenon near the air-tissue interface using a simulated phantom, such as air gap, air cylinder, and air cavity, the amount of rebuldup along the various field sizes and air cavity dimensions was measured. The results are as follows. 1. As the field size becomes larger in comparison with the cavity size, or as the cavity size gets bigger when the field size is equal to the cavity size, rebuildup decreases. 2. When the distance between the phantom surface and the air cavity is less than 1.5cm, there is prominent rebuildup. And when the distance is more than 1.5cm, rebuildup is relatively constant, 3. The change according to the depth of the cavity is affected by the field size and the cavity size, rebuildup usually increases when the depth of the cavity increases. 4. It is suggested that tissue equivalent material should be applied on the skin to make tissue thickness over the air cavity more than 1.5cm and that the field size should include the air cavity with at least 1cm margin.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.29 no.2 s.43
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• pp.105-130
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• 2003

Human skin equivalents, also designated as cultured skin substitute (Boyce and Warden, 2002) or organotypic co-cultures (Maas-Szabowski et al., 1999, 2000, 2003), are three-dimensional systems that are engineered by seeding fibroblasts into a three-dimensional dermal matrix. Such a dermal equivalent is then subsequently seeded with human keratinocytes. After cell attachment, the culture is kept first under submerged condition to allow keratinocyte proliferation. Thereafter, the culture is lifted the air-liquid interface (A/L) to expose the epidermal compartment to the air, and to further induce keratinocyte differentiation. During the air-exposure, nutrients from the medium will diffuse through the underlying dermal substrate towards the epidermal compartment and support keratinocyte proliferation and differentiation. Under these conditions, a HSE is formed that shows high similarity with the native tissue from which it was derived (Figure 1) (Bell et at., 1981; Boyce et al., 1988; Ponec et al., 1997;El Ghalbzouri et al.., 2002).

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.463-486
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• 1995

The effect of moistening and air-drying of acid-conditioned dentin before priming on the formation of resin-dentin hybrid zone was investigated, Freshly extracted human molars were used and divided at random into 5 groups, Groups 1 - 3 consisted of specimens conditioned with 10 % phosphoric acid for 20 seconds; Group 1 served as a control in which the conditioned dentin was simply blot-dried with a damp facial tissue; Group 2 was air dried for 30 seconds ; Group 3 was air dried for 30 seconds and immediately remoistened for 10 seconds with air-water syringe. and then the specimen was blot-dried with a damp facial tissue. Groups 4-5 were not acid conditioned ; In group 4, the smear layer on the dentin was blot dried before primer placement; Group 5 was air dried only for 30 seconds, The acetone-based primer and bonding agent of All Bond 2 (Bisco. Inc., USA) and composite resin (Z-100, 3M Dental products, USA) were applied for acid conditioned dentin and non-conditioned dentin. The morphologic ultrastructure of resin-dentin hybrid zone was examined by the use of SEM and TEM. and the existence of inorganic material and analysis of Ca/P weight-percent ratio in the resin-dentin hybrid zone were revealed by the EDAX, The results were as follows : 1. In the moistened specimens from acid-conditioned groups, the resin penetrated about 3-$4{\mu}m$ into dentin and the denatured collagen smear layer was not present at the surface. The resin tag was formed to a thickeness of 3-$4{\mu}m$ at the upper part of dentinal tubule and compactively connected to each other by means of many lateral branching. 2. In the air-dried specimens from acid-conditioned groups, the resin penetrated about 2.0-$2.5\;{\mu}m$ into dentin and an upper thin black layer to a thickness of 30-35nm was identified between adhesive resin and demineralized collagen layer. The resin tag to have a diameter of $2.5{\mu}m$ was formed at the upper part of dentinal tubule. However the funnel shape of the tag was not notable compared to the moistened specimens. 3. In the remoistened specimens from acid conditioned groups, the resin penetrated about 2.0-$2.5{\mu}m$ into dentin and an upper black layer was not present. The resin tag at the upper part of dentinal tubule was formed less than $2{\mu}m$ and was weakly connected to each other by means of few lateral branching. 4. In the non-conditioned groups, the smear layer was formed to a thickness of $0.5{\mu}m$ at dentin surface. However, the resin-dentin hybrid zone was not identified by TEM. The evidence of resin penetration into intertubular and intratubular dentin did not show. 5. All the acid-conditioned groups showed that the detected calcium and phosphorus weight percent ratios at the $2{\mu}m$ upper portion from the resin-dentin interface into the resin were much higher than that at the $2{\mu}m$ lower portion from the resin-dentin interface to dentin. (P<0.01).

• Journal of the Ergonomics Society of Korea
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• v.29 no.4
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• pp.639-646
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• 2010

The APAM's quantitative effectiveness and comparative study in preventing and treating pressure ulcer has not been sufficiently evaluated mainly because of uncertainty of pressure load input and lack of interpretation of dynamic perfusion recovery characteristics of soft tissue. The purpose of this paper was to quantify and analyze the alternating pressure characteristics of APAM as a preventive measure for pressure ulcers. To quantify the alternating load to human body, we introduced alternating pressure profile concept and developed parametric model of the profile. Regarding pressure level and cycle time, 3 global and 7 local periodic parameters were used to define the profile such as light, standard, typical and heavy duty profile shape. Pressure impulse ratio of light duty is the lowest but pressure fluctuation is significantly high. For the same duty shape, contact conditions are changed with alternating cycle time and more dramatically in shorter alternating cycle time conditions. We can conclude that if we use shorter alternating cycle time on APAM's operation we can get more positive effects regarding to inflated contact time condition. We proposed the quantitative methods on tissue viability study of external loading by simultaneous measurement of interface pressure and tissue perfusion with proper alternating pressure profile conditions.

• Journal of Pharmaceutical Investigation
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• v.40 no.6
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• pp.321-332
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• 2010

Growing interest in the nasal route as a drug delivery system calls for a reliable in vitro model which is crucial for efficiently evaluating drug transport through the nasal cells. Various in vitro cell culture systems has thus been developed to displace the ex vivo excised nasal tissue and in vivo animal models. Due to species difference, results from animal studies are not sufficient for estimating the drug absorption kinetics in humans. However, the difficulty in obtaining reliable human tissue source limits the use of primary culture of human nasal epithelial cells. This shortage of human nasal tissue has therefore prompted studies on the "passage" culture of nasal epithelial cells. A serially passaged primary human nasal epithelial cell monolayer system developed by the air-liquid interface (ALI) culture is known to promote the differentiation of cilia and mucin gene and maintain high TEER values. Recent studies on the in vitro nasal cell culture systems for drug transport studies are reviewed in this article.

• Proceedings of the KOSOMBE Conference
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• v.1995 no.11
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• pp.14-17
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• 1995

An in vitro construct of three dimensional artificial skin equivalent has been engineered using human cervical epithelial cells and human foreskin fibroblasts with a matrix of bovine type I collagen. Two cell lines were established from cervical uteri cancer tissues which have the HPV(human papillomavirus)18 genome. These two cell lines came from the same origin but have slight differencies in growth rate and tumorigenicity. The organotypic raft culturing of epithelial cells were accomplished at air-liquid interface. The differentiation related characteristics were examined by immunohistochemistry using monoclonal antibodies against EGFreceptor, cytokeratin 5/6/18 as proliferation markers and against filaggrin, involucrin, and cytokeratin 10/13 as differentiation marker. We have obtained the stratification and the differentiation in the artificial skin equivalent, and differentiation-related proteins were expressed more in the C3-artificial skin, and proteins of proliferation were expressed more in the C3N-artificial skin, relatively. We found that reconstituted artificial skin have the same characteristics of differentiation proteins of original tissue or cells of human body.