• Journal of Chest Surgery
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• v.34 no.12
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• pp.917-923
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• 2001

Background : Bronchial sleeve resection for centrally located primary lung cancer is a lung-parenchyma-sparing operation in patients whose predicted postoperative lung function is expected to diminished markedly. Because of its potential bronchial anastomotic complications, it is considered to be an alternative to pneumonectomy. However, since sleeve lobectomy yielded survival results equal to at least those of pneumonectomy, as well as better functional results, it became and accepted standard procedure for patients with lung cancer who have anatomically suitable tumors, regardless of lung function. In this study, from analyzing of occurrence rate of postoperative complication and survival rate, we wish to investigate the validity of sleeve resection for primary lung cancer. Material and Method : From January 1989 to December 1998, 45 bronchial sleeve resections were carried out in the Department of Thoracic Surgery of Seoul National University Hospital. We included 40 men and 5 women, whose ages ranged from 23 to 72 years with mean age of 57 years. Histologic type was squamous cell carcinoma in 35 patients, adenocarcinoma in 7, and adenosquamous cell carcinoma in 1 patients. Right upper lobectomy was peformed in 24 patients, left upper lobectomy in 11, left lower lobectomy in 3, right lower lobectomy in 1, right middle lobecomy and right lower lobectomy in 3, right upper lobectomy and right middle lobecomy in 2, and left pneumonectomy in 1 patient. Postoperative stage was Ib in 11, IIa in 3, IIb in 16, IIIa in 13, and IIIb in 2 patients. Result: Postoperative complications were as follows; atelectasis in 9, persistent air leakage for more than 7 days was in 7 patients, prolonged pleural effusion for more than 2 weeks in 7, pneumonia in 2, chylothorax in 1, and disruption of anastomosis in 1. Hospital mortality was in 3 patients. During follow-up period, bronchial stricture at anastomotic site were found in 7 patients under bronchoscopy, Average follow-up duration of survivals(n=42) was 35.5$\pm$29 months. All of stage I patients were survived, and 3 year survival rate of stage II and III patients were 63%, 21%, respectively. According to Nstage, all of N0 patients were survived and 3 year survival rates of Nl and N2 were 63% and 28% respectively. Conclusion: We suggest that this sleeve resection, which is technically demanding, should be considered in patients with centrally located lung cancer, because ttlis lung-saving operation is safer than pneumonectomy and is equally curative.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.37-44
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• 2007

Background: It is known that long-term survival rate in patients underwent bronchial sleeve lobectomy for primary lung cancer is at least equal to that in patients underwent pneumonectomy, and bronchial sleeve lobectomy is performed in patients with suitable tumor location even in patients have adequate pulmonary function. Sleeve pneumonectomy is performed when carina was invaded by tumor or tumor location was near to the carina. We performed this study to know our results of sleeve resection for primary lung cancer. Material and Method: We analyzed retrospectively the medical records of 45 patients who underwent sleeve lobectomy or sleeve pneumonectomy for primary lung cancer by one thoracic surgeon from May 1990 to July 2003 in Department of Thoracic & Cardiovascular Surgery, College of Medicine, Kyung Hee University. Follow-up loss was absent and last follow-up was performed in April 5, 2005. Kaplan-Meyer method and log-lank test were used to know long-term survival rate and p-value. Result: Mean age was 60 years old and male to female ratio 41:1. Histologic types were squamous cell carcinoma were 39, adenocarcinoma were 4, and others were 2 patients. Pathologic stages were I 14, II 14, and III 17 patients. Nodal stages were N0 23, N1 13, and N2 9 patients. Types of operation were sleeve lobectomy 40 and sleeve pneumonectomy 5 patients. Operative mortality was 3 patients and its cause was respiratory complications. Early complications were pneumonia 4, atelectasis 8, air leakage more than 7 days 6, and atrial fibrillation 4 patients. In 19 patients tumor was recurred. Local recurrence was 10 and systemic metastasis was 9 patients. Overall 5, 10-year survival rate were 54.2%, 42.5%. The 5, 10-year survival rates according to the pathologic stage were 83.9%, 67.1% in stage I, 55%, 47.1% in II, 33.3%, 25% in III, and significance difference was present between stage I and III. The 5, 10-year survival rate according to the lymph node involvement were 63.9%, 54.6% in N0, 53,8%, 46.5% in N1, 28.5%, 14.2% in N2, and significance difference was present between N0 and N2. Conclusion: Because bronchial sleeve lobectomy for primary lung cancer could be performed safely and shows acceptable long-term survival rate, it could be considered primary in case of suitable tumor location if complete resection is possible. Although sleeve pneumonectomy for primary lung cancer shows somewhat high operative mortality rate, it could be considered in view of curative treatment.

• Journal of the Korean Vacuum Society
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• v.15 no.6
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• pp.563-575
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• 2006

Ti(C,N) films are synthesized by pulsed DC plasma enhanced chemical vapor deposition (PEMOCVD) using metal-organic compounds of tetrakis diethylamide titanium at $200-300^{\circ}C$. To compare plasma parameter, in this study, $H_2$ and $He/H_2$ gases are used as carrier gas. The effect of $N_2\;and\;NH_3$ gases as reactive gas is also evaluated in reduction of C content of the films. Radical formation and ionization behaviors in plasma are analyzed in-situ by optical emission spectroscopy (OES) at various pulsed bias voltages and gas species. He and $H_2$ mixture is very effective in enhancing ionization of radicals, especially for the $N_2$. Ammonia $(NH_3)$ gas also highly reduces the formation of CN radical, thereby decreasing C content of Ti(C, N) films in a great deal. The microhardness of film is obtained to be $1,250\;Hk_{0.01}\;to\;1,760\;Hk_{0.01}$ depending on gas species and bias voltage. Higher hardness can be obtained under the conditions of $H_2\;and\;N_2$ gases as well as bias voltage of 600 V. Hf(C, N) films were also obtained by pulsed DC PEMOCYB from tetrakis diethyl-amide hafnium and $N_2/He-H_2$ mixture. The depositions were carried out at temperature of below $300^{\circ}C$, total chamber pressure of 1 Torr and varying the deposition parameters. Influences of the nitrogen contents in the plasma decreased the growth rate and attributed to amorphous components, to the high carbon content of the film. In XRD analysis the domain lattice plain was (111) direction and the maximum microhardness was observed to be $2,460\;Hk_{0.025}$ for a Hf(C,N) film grown under -600 V and 0.1 flow rate of nitrogen. The optical emission spectra measured during PEMOCVD processes of Hf(C, N) film growth were also discussed. $N_2,\;N_2^+$, H, He, CH, CN radicals and metal species(Hf) were detected and CH, CN radicals that make an important role of total PEMOCVD process increased carbon content.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.17-25
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• 1998

Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

• The Korean Journal of Nuclear Medicine
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• v.39 no.1
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• pp.34-43
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• 2005

Purpose: $^{99m}Tc$-sestamibi(MIBI) and $^{99m}Tc$-tetrofosmin have been used as substrates for P-glycoprotein (Pgp) and multidrug resistance associated protein (MRP), which are closely associated with multidrug resistance of the tumors. To understand different handling of radiotracers in cancer cell lines expressing Pgp and MRP, we compared cellular uptakes of $^{99m}Tc$-MIBI and $^{99m}Tc$-tetrofosmin. The effects of cyclosporin A (CsA), well-known multidrug resistant reversing agent, on the uptake of both tracers were also compared. Materials and Methods: HCT15/CL02 human colorectal cancer cells for Pgp expressing cells, and human non-small cell lung cancer A549 cells for MRP expressing cells, were used for in vitro and in vivo studies. RT-PCR, western blot analysis and immunohistochemistry were used for detection of Pgp and MRP. MDR-reversal effect with CsA was evaluated at different drug concentrations after incubation with MIBI or tetrofosmin. Radioactivities of supernatant and pellet were measured with gamma well counter. Tumoral uptake of the tracers were measured from tumor bearing nude mice treated with or without CsA. Results: RT-PCR, western blot analysis of the cells and irnrnunochemical staining revealed selective expression of Pgp and MRP for HCY15/CL02 and A549 cells, respectively. There were no significant difference in cellular uptakes of both tracers in HCT15/CL02 cells, but MIBI uptake was slightly higher than that of tetrofosmin in A549 cells. Co-incubation with CsA resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Uptake of MIBI or tetrofosmin in HCT15/CL02 cells was increased by 10- and 2.4-fold, and by 7.5 and 6.3-fold in A549 cells, respectively. Percentage increase of MIBI was higher than that of tetrofosmin with CsA for both cells (p<0.05). In vivo biodistribution study showed that MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were progressively increased by the time, up to 240 min with CsA. But increases in tumoral uptake were not significantly different between MIBI and tetrofosmin for both tumors. Conclusion: MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators in vitro, but these differences were not evident in vivo tumoral uptake. Both MIBI and tetrofosmin seem to be suitable tracers for imaging Pgp- and MRP-mediated drug resistance in tumors.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.54-59
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• 2017

Purpose The present study aimed at assessing the effectiveness of the respiratory gating method used in the flow mode and additional localized respiratory-gated imaging, which differs from the step and go method. Materials and Methods Respiratory gated imaging was performed in the flow mode to twenty patients with lung cancer (10 patients with stable signals and 10 patients with unstable signals), who underwent PET/CT scanning of the torso using Biograph mCT Flow PET/CT at Bundang Seoul University Hospital from June 2016 to September 2016. Additional images of the lungs were obtained by using the respiratory gating method. SUVmax, SUVmean, and Tumor Volume ($cm^3$) of non-gating images, gating images, and additional lung gating images were found with Syngo,bia (Siemens, Germany). A paired t-test was performed with GraphPad Prism6, and changes in the width of the amplitude range were compared between the two types of gating images. Results The following results were obtained from all patients when the respiratory gating method was applied: $SUV_{max}=9.43{\pm}3.93$, $SUV_{mean}=1.77{\pm}0.89$, and $Tumor\;Volume=4.17{\pm}2.41$ for the non-gating images, $SUV_{max}=10.08{\pm}4.07$, $SUV_{mean}=1.75{\pm}0.81$, and $Tumor\;Volume=3.56{\pm}2.11$ for the gating images, and $SUV_{max}=10.86{\pm}4.36$, $SUV_{mean}=1.77{\pm}0.85$, $Tumor\;Volume=3.36{\pm}1.98$ for the additional lung gating images. No statistically significant difference in the values of $SUV_{mean}$ was found between the non-gating and gating images, and between the gating and lung gating images (P>0.05). A significant difference in the values of $SUV_{max}$ and Tumor Volume were found between the aforementioned groups (P<0.05). The width of the amplitude range was smaller for lung gating images than gating images for 12 from 20 patients (3 patients with stable signals, 9 patients with unstable signals). Conclusion In PET/CT scanning using the respiratory gating method in the flow mode, any lesion movements caused by respiration were adjusted; therefore, more accurate measurements of $SUV_{max}$, and Tumor Volume could be obtained from the gating images than the non-gating images in this study. In addition, the width of the amplitude range decreased according to the stability of respiration to a more significant degree in the additional lung gating images than the gating images. We found that gating images provide information that is more useful for diagnosis than the one provided by non-gating images. For patients with irregular signals, it may be helpful to perform localized scanning additionally if time allows.

• Korean Journal of Organic Agriculture
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• v.22 no.4
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• pp.731-742
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• 2014

In the current study, we investigated effects of a combination of earthworm casting, environment-friendly by-product fertilizer, and cultivation soil of Gymnocalycium mihanovichii in a heavy fertilizing culture on diameter, height, numbers of tubercles, and chemical properties of soil thereby elucidating optimal mixture ratio for securing production as well as providing nutrients throughout cultivation period. The Gymnocalycium mihanovichii var 'Ihong', one of grafted cactus for export (Rootstock: 9 cm, Scion: $1.5{\times}1.3cm$ grafted cactus) was cultured in plastic houses of Agricultural Technology Center located in Naegok-dong, Seocho-gu, Seoul from June, 2013 through December, 2013. For the control group, a mixture of sand and fertilizer (50:50) was used as this ratio is widely utilized in farmhouses. In contrast, a variety mixtures of sand and earthworm casting that was produced with food wastes was compared; the mixture ratios were 80:20, 60:40, 40:60, 20:80, and 0:100 and pH for these mixtures were found to be similar each other (ranging between 7.1 and 7.4) which is in an appropriate range (pH 6.5-7.5) for cultivation of G. mihanovichii. The organic content was increasing along with increasing contents of earthworm casting ratio while it was lower than the treatment practice group (32-43 mg/kg vs. 55 mg/kg). The content of exchangeable cation was also increasing as the ratio of earthworm casting was elevated; although levels of $K^+$, $Na^+$, and $Mg^{2+}$ were lower than the treatment practice group, the level of $Ca^{2+}$ was higher ($9.1cmol^+/kg$ and $11.5-33.7cmol^+/kg$ in the treatment practice group and the earthworm casting group, respectively). Three months after grafting, diameters of G. mihanovichii were compared with the control group; consequently, there was a significant difference noted in between the earthworm casting group and the control group (31.39 mm vs. 32.46-37.59 mm). After 5 months, growth characteristics of G. mihanovichii were evaluated. Similarly, the diameter of G. mihanovichii was significantly increasing in the group with higher ratio of earthworm casting treatment (32.63 mm vs. 32.49-37.59 mm). The height of tubercles was 2.63 mm in the control group while it was significantly elevating along with the ratio of earthworm casting mixture. The more numbers of tubercles, the more incomes for farm-houses; as results, higher mixture ration of earthworm casting resulted more numbers of tubercles compared to the control group (2.7 vs. 3.2-8.3 ea). In particular, in the earthworm casting groups with 80% and 100% ratios, the numbers of tubercles were 6.2 and 8.3 ea, respectively, which is 2.5 times more than those of the control group. These results indicate that earthworm casting treatment may be utilized in G. mihanovichii farming houses for short term production of tubercles. In the group with 40% and 60% of earthworm casting mixture, the numbers of tubercles were found to be 4.5 and 4.8 ea, respectively which is higher than the control group as well; in these groups, there were no issues with soil drainage as well as moss formation. Given the analysis results of growth characteristics of G. mihanovichii, it was concluded that 40% and 60% of earthworm casting mixture might be the optimal ratios.

• Journal of Animal Environmental Science
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• v.12 no.3
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• pp.141-150
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• 2006

To optimise the efficient use of nutrients in pig slurry is to cultivate friendly environmental crops. This field survey is to investigate the actual conditions of pig slurry utilization for cultivation of crops in the agricultural farm, based on the survey for 407 selected farms in 9 provinces included 78 counties in Korea. The results obtained in this survey were summarized as follow ; The motive which came to use pig slurry in the agricultural farm were production of friendly environmental crops (29.7%), economy of chemical fertilizer (25.1%), spontaneously (19.2%), inducement of neighboring farmhouse (16.0%), increase of soil fertility (9.3%), and the others (0.7%), respectively. The proportions of pig slurry application land were 56.5% for.ice paddy, 22.6% for dry field, 13.3% for orchard, 4.4% for controlled agriculture and 3.2% for other, respectively. The number of times of pig slurry utilization per year were once (48.9%), twice (31.9%), thrice (14.0%), and the others (5.2%), respectively. The controversial points of pig slurry utilization were malodor (54.1%), insufficiency of spread equipment (22.1%), inconvenience (14.5%), over application (3.4%), over cost (2.9%), heavy metal (1.7%), sanitation (1.0%) and the other (0.2%), respectively. The results indicated that pig slurry could be used as fertilizer source of friendly environmental crops, but further studies are needed to determine the application method and value of the pig slurry for crop cultivation.

• Journal of Animal Environmental Science
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• v.16 no.1
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• pp.81-92
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• 2010

This study was conducted to evaluate the effects of fermented diets including liquid by-products on nutrient digestibility and nitrogen balance in growing pigs. Treatments were 1) CON (basal diet), 2) F (fermented diet with basal diet), 3) KF (fermented diet with basal diet including 30% kale pomace), 4) AF (fermented diet with basal diet including 30% angelica keiskei pomace), 5) CF (fermented diet with basal diet including 30% carrot pomace) and 6) OF (fermented diet with basal diet including 30% grape pomace). A total of 24 pigs (41.74kg average initial body weight, Landrace $\times$ Yorkshire $\times$ Duroc), were assigned to 6 treatments, 4 replicates and 1 pig per metabolic cage in a randomized complete block (RCB) design. Pigs were housed in $0.5\times1.3m$ metabolic cage in a 17d digestibility trial. During the entire experimental period, Digestibility of dry matter (p<0.05) of treatment CON, F and CF were higher than other treatments. In crude protein digestibility, treatment F was higher than treatment AF and GF (p<0.05). Treatment GF showed the lowest digestibility of crude fiber among all treatments (p<0.05). In ether extract digestibility, treatment AF and CF showed higher than other treatments (p<0.05) except KF treatment. CF treatment showed the best digestibility of ash among all treatments (p<0.05). Whereas, For Ca and P digestibility, CF and OF treatments were improved than other treatments (p<0.05). Energy digestibility (p<0.05) of CON, F and CF treatments were higher than KF, AF and GF treatments. In total essential amino acid digestibility, F treatment was improved than AF, CF and GF treatments (p<0.05). In total non-essential amino acid digestibility, F treatment was higher than CON, AF and GF treatments (p<0.05). In total amino acid digestibility, F treatment was higher than AF and CF treatments (p<0.05) and GF treatment showed the lowest digestibility (p<0.05). In fecal nitrogen excretion ratio, GF treatment was greatest among all treatments (p<0.05) and F treatment was decreased than other treatments (p<0.05). In urinary nitrogen excretion ratio, CON and GF treatments showed the lowest among all treatments (p<0.05). In nitrogen retention ratio, CON treatment showed the high and KF treatment showed the lost among all treatments (p<0.05). Therefore, this experiment suggested that fermented diet could improve nutrient and amino acid digestibilities of growing pigs.