Lee Kang Kyoo;Park Kyung Ran;Lee Jong Young;Lee Yong Ha
Radiation Oncology Journal
/
v.15
no.3
/
pp.215-224
/
1997
Purpose : Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM) . We Present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. Materials and Methods : Rrom January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a sin91e fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. Results : Angiography was available in 13 patients with a follow-up Period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One Patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. Conclusion : We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.
Background: Lymphangioleiomyomatosis(LAM) is a very rare disease occurring in women of reproductive age and leading to progressive respiratory failure despite therapy. But the natural history of this disease is uncertain and although anti-estrogenic agents have been used for more than twenty years, it's efficacy is still in debate. This study was performed to enhance understanding of this fatal disease in Korea by examining clinical, radiological, and pathologic findings of all the previously reported cases of LAM on Korea along with four new cases of LAM whom we report in this paper. Method: Out of twlve cases of LAM previously unpublished and published in domestic papers, two cases whose diagnoses were considered doubtful after review of clinical, radiological, and pathologic findings at "Asian Congress on Lymphangioleiomyomatosis" at Kyoto, Japan in feburary of 1993 were excluded from this study. Six cases which were reported previously and four new cases of LAM whom we report in this paper were analysed for the clinical, radiological, and pathologic characteristics. Results: All ten patients were women with mean age of $33{\pm}7$. The most common symptom was exertional dyspnea and most patients had history of pneumothoraces. Pulmonary function tests showed decreased diffusing capacity. on high resolution computed tomography(HRCT), all the cases had characteristic cysts. Most of the patients did not respond to hormonal therapy. Conclusion: In women of reproductive age, presenting with dyspnea who has a history of pneumothorax, LAM should always be considered as one of the diagnostic possibilities. If suspected, HRCT should be done to look for characteristic cysts and if needed, open lung biopsy should be done to confirm the diagnosis.
Jung, Eun Jung;Kim, Yang Ki;Lee, Young Mok;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong Hoon;Kim, Do Jin;Park, Choon Sik;Hwang, Jung Hwa
Tuberculosis and Respiratory Diseases
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v.66
no.4
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pp.288-294
/
2009
Background: A lung hyperinflation, or air trapping, caused by expiratory flow-limitation contributes to dyspnea in patients with chronic obstructive pulmonary disease (COPD). Forced expiratory volume in 1 second ($FEV_1$) has served as an important diagnostic measurement of COPD, but does not correlate with patient-centered outcomes such as dyspnea. Therefore, this study was performed to investigate the role of radiologic quantity in evaluating the dyspnea in patients with COPD by measuring lung hyperinflation in chest x-ray and high resolution chest tomography (HRCT). Methods: Fifty patients with COPD were enrolled in this study. Their subjective dyspnea score (modified Borg scale dyspnea index), spirometry, and lung volume were measured. Simultaneous hyperinflations of chest x-ray score ("chest score") and degree of emphysema of HRCT ("HRCT score") were measured. The "chest score" were composed of lung length, retrosternal space width, and height of the arc of the diaphragm and "HRCT score" were composed of severity and extent of emphysema. Results: The mean age of patients was 69 years old and their mean $FEV_1$ was 51.7%. The Borg score significantly correlated with parameters of spirometry and lung volume, including FVC, $FEV_1$, $FEV_1$/FVC, RV, RV/TLC, and DLCO. The Borg score correlated well with "HRCT score", but did not correlate with "chest score". Also, the Borg scale correlates inversely with body mass index. Conclusion: The quantity of emphysema on chest HRCT may serve as an objective marker of dyspnea in patients with COPD.
Kim Wuon-Shik;Jeong Hwan-Taek;No Ki-Yong;Bae Jang-Ho
Progress in Medical Physics
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v.16
no.4
/
pp.207-213
/
2005
The severity of carotid Intima-media thickness (IMT) is an Independent predictor of atherosclerosis which causes transient cerebral ischemia, stroke, and coronary events such as myocardial Infarction. The IMT consists of Intima thickness (IT) and media thickness (MT). However, the Individual clinical significance of IT and MT has not been well studied. We devised a method of measuring IT, MT, and IMT using B-mode ultrasound Image processing technique for the diagnosis of atherosclerosis. To inspect the clinical significance of IT, MT, and IMT, one hundred forty-four consecutive patients (mean age; 57 years old, 72 males) were underwent common carotid artery scanning using high-resolution ultrasound. Results showed that, the IT (p<0.05), MT (p<0.05) as well as IMT (p<0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hyperiension showed significantly thicker IT (p<0.01), MT (p<0.001), and IMT (p<0.001). However, only IT was thicker in patients with smoking (p<0.01). The IT (r=0.374, p=0.001), MT (r=0.433, p=0.000), and IMT (r=0.479, p=0.000) showed positive correlation with age. The coefficients of determination ($r^2$) were estimated to be $92.4\%$ for IMT and MT, $49.1\%$ for IMT and IT, and $27.4\%$ for IT and MT. This result suggests that the Intima layer of the carotid artery has a different physiology with the media layer.
Kim, Dae Jung;Kim, Joo Hee;Lim, Joon Seok;Chung, Jae-Joon;Yu, Jeong-Sik;Kim, Myeong-Jin;Kim, Ki Whang
Investigative Magnetic Resonance Imaging
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v.18
no.4
/
pp.323-331
/
2014
Purpose : To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. Materials and Methods: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. Results: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p<0.001). Compared to MR without distension, MR with gel filling had no significant differences in prediction of CRM or sphincter involvement (p>0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy ($6.8{\pm}1.6cm$ vs. $5.8{\pm}1.6cm$, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. Conclusion: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.
Background: KLK3 gene products, like human prostate-specific antigen (PSA), are important biomarkers in the clinical diagnosis of prostate cancer (PCa). G protein-coupled receptor RFX6, C2orf43 and FOXP4 signaling plays important roles in the development of PCa. However, associations of these genes with PCa in northern Chinese men remain to be detailed. This study aimed to investigate their impact on occurrence and level of malignancy. Methods: All subjects were from Beijing and Tianjin, including 266 cases with prostate cancer and 288 normal individuals as controls. We evaluated associations between clinical covariates (age at diagnosis, prostate specific antigen, Gleason score, tumor stage and aggressive) and 6 candidate PCa risk loci, genotyped by PCR- high resolution melting curve and sequencing methods. Results: Case-control analysis of allelic frequency of PCa associated with PCa showed that one of the 6 candidate risk loci, rs339331 in the RFX6 gene, was associated with reduced risk of prostate cancer (odds ratio (OR) = 0.73, 95% confidence interval (CI) =0.57-0.94, P = 0.013) in northern Chinese men. In addition, subjects with CX (CC+TC) genotypes had a decreased risk for prostrate cancer compared to those carrying the TT homozygote (OR =0.64, 95% CI = 0.45- 0.90, P = 0.008). The TT genotype of 13q22 (rs9600079, T) was associated with tumor stage (P=0.044, OR=2.34, 95% CI=0.94-5.87). Other SNPs were not significantly associated with clinical covariates in prostate cancer (P > 0.05). Conclusions. rs339331 in the RFX6 gene may be associated with prostate cancer as a susceptibility locus in northern Chinese men.
Recent fMRI and EEG research for neural representations of action concepts insist that processing of action concepts evoke the simulation of sensory-motor information. Moreover, there are several behavioral studies showing that understanding of action verbs or sentences describing actions interfere or facilitate current action performance. However, it is unclear that online interaction between processing of action concepts and current action is based on the simulation of sensory-motor information, or other neural mechanisms. The present research aims to explore the underlying neural mechanism that how the perception of action language influence the performance of current action using high-spacial temporal resolution EEG and multiple source analysis techniques. For this, participants were asked to perform a cued-motor reaction task in which button-pressing hand action and pedal-stepping foot action were required according to the color of the cue, and we presented auditorily action verbs describing the responding actions (i.e., /press/, /step/, /stop/) just before the color cue and examined the interaction effect from the semantic congruency between the action verbs and the current action. Behavioral results revealed consistently a facilitatory effect when action verbs and responding actions were semantically congruent in both button-pressing and pedal-stepping actions, and an inhibitory effect when semantically incongruent in the button-pressing action condition. In the results of EEG source waveform analysis, the semantic congruency effects between action verbs and the responding actions were observed in the Wernicke's area during the perception of action verbs, in the anterior cingulate gyrus and the supplementary motor area (SMA) at the time when the motor-cue was presented, and in the SMA and primary motor cortex (M1) during action execution stage. Based on the current findings, we argue that perceived action verbs evoke the facilitation/inhibition effect by influencing the expectation and preparation stage of following actions rather than the directly activating the particular motor cortex. Finally we discussed the implication on the neural representation of action concepts and methodological limitations of the current research.
Seo, Young-Jin;Song, Si Young;Ahn, Jung Tae;Kim, Yoon-Sang;Ko, Jun Ho;Jang, Seong-Wook;Yoo, Yon-Sik
Journal of the Korean Arthroscopy Society
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v.16
no.2
/
pp.160-166
/
2012
Purpose: The aim of this study was to determine the patterns of the stress distribution within the reconstructed anterior cruciate ligament (ACL) double bundles in response to an anterior tibial load and rotatory load at $45^{\circ}$ flexed knee model by use of a 3-dimensional finite element analysis (FEM). Materials and Methods: The $0^{\circ}$ and $45^{\circ}$ flexed 3-D knee model were reconstructed based on the high resolution computed tomography (CT) images from the right knee of a healthy male subject. To simulate double bundle ACL reconstruction, in $0^{\circ}$ analytic model, four 7 mm diameter tunnels were created at the center of each anteromedial (AM) and posterolateral (PL) footprints on the femur and tibia. The grafts were inserted into the corresponding bone tunnels and then reconstructed knee model was flexed to $45^{\circ}$. As a next step, the 5 mm anterior tibial load and internal rotational load of $10^{\circ}$ were applied on the final Computer aided design (CAD) model. And then stress patterns of each bundle were assessed using a finite element analysis. Results: In response to the 5 mm of anterior tibial load, the AM bundle showed increased stresses around the tibial and femoral attachment sites; especially in the anterior aspect of the bundle. In the PL bundle, the highest stress concentration was also noticed on the anterior aspect of the bundle. Under $10^{\circ}$ internal rotational load, the stress concentration was predominant around the anterior aspect of the tibial attachment site within the AM bundle. The PL bundle also showed highest stress concentration on the anterior aspect of the bundle. Conclusion: Although the stress patterns were not identical among the AM and PL bundle, there were common trends in the stress distribution. The stress concentration was predominant on the anterior aspect of both bundles in response to the anterior tibial load and rotatory load.
Kim, Dae-Eun;Lee, Bum-Shik;Kim, Mun-Churl;Kim, Byung-Sun;Hahm, Sang-Jin;Lee, Keun-Sik
Journal of Broadcast Engineering
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v.17
no.4
/
pp.640-658
/
2012
One of the existing terrestrial multi-channel DTV service frameworks, called KoreaView, provides four programs, composed of MPEG-2 based one HD video and H.264/AVC based three SD videos within one single 6MHz frequency bandwidth. However the additional 3 SD videos can not provide enough quality due to its reduced spatial resolution and low target bitrates. In this paper, we propose a framework, which is called a terrestrial multi-channel high quality hybrid DTV service, to overcome such a weakness of KoreaView services. In the proposed framework, the three additional SD videos are encoded based on an H.264/SVC Spatial Base layer, which is compliant with H.264/AVC, and are delivered via broadcasting networks. On the other hand, and the corresponding three additional HD videos are encoded based on an H.264/SVC Spatial Enhancement layer, which are transmitted over broadband networks such as Internet, thus allowing the three additional videos for users with better quality of experience. In order to verify the effectiveness of the proposed framework, various experimental results are provided for real video contents being used for DTV services. First, the experimental results show that, when the SD sequences are encoded by the H.264/SVC Spatial Base layer at a target bitrate of 1.5Mbps, the resulting PSNR values are ranged from 34.5dB to 42.9dB, which is a sufficient level of service quality. Also it is noted that 690kbps-8,200kbps are needed for the HD test sequences when they are encoded in the H.264/SVC Spatial Enhancement layer at similar PSNR values for the same HD sequences encoded by MPEG-2 at a target bitrate of 12 Mbps.
Park, Jong Hoon;Lee, Han Rim;Kim, Chan Hyeong;Kim, Sung Hun;Kim, Seonghoon;Lee, Se Byeong
Progress in Medical Physics
/
v.26
no.1
/
pp.42-51
/
2015
In proton therapy, verification of proton dose distribution is important to treat cancer precisely and to enhance patients' safety. To verify proton dose distribution, in a previous study, our team incorporated a vertically-aligned one-dimensional array detection system. We measured 2D prompt-gamma distribution moving the developed detection system in the longitudinal direction and verified similarity between 2D prompt-gamma distribution and 2D proton dose distribution. In the present, we have developed two-dimension prompt-gamma measurement system consisted of a 2D parallel-hole collimator, 2D array-type NaI(Tl) scintillators, and multi-anode PMT (MA-PMT) to measure 2D prompt-gamma distribution in real time. The developed measurement system was tested with $^{22}Na$ (0.511 and 1.275 MeV) and $^{137}Cs$ (0.662 MeV) gamma sources, and the energy resolutions of 0.511, 0.662 and 1.275 MeV were $10.9%{\pm}0.23p%$, $9.8%{\pm}0.18p%$ and $6.4%{\pm}0.24p%$, respectively. Further, the energy resolution of the high gamma energy (3.416 MeV) of double escape peak from Am-Be source was $11.4%{\pm}3.6p%$. To estimate the performance of the developed measurement system, we measured 2D prompt-gamma distribution generated by PMMA phantom irradiated with 45 MeV proton beam of 0.5 nA. As a result of comparing a EBT film result, 2D prompt-gamma distribution measured for $9{\times}10^9$ protons is similar to 2D proton dose distribution. In addition, the 45 MeV estimated beam range by profile distribution of 2D prompt gamma distribution was $17.0{\pm}0.4mm$ and was intimately related with the proton beam range of 17.4 mm.
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